Efficacy of Local Anaesthesia and Simplicity of Mesh Plug Technique in Open Inguinal Hernia Repair in Patients above 60 years of age.
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Background: Local anaesthesia offers several advantages over other types of anaesthesia because it is limited to a small body area. This study evaluate the efficacy of local anaesthesia and the simple of mesh plug technique in open inguinal hernia repair, particularly in patients over the age of 60 years. Methods: A prospective study was conducted on 150 patients above the age of 60 who were admitted from a specialized hernia clinic in the Armed Forces Hospital, Southern Region, Saudi Arabia. They underwent inguinal hernia repair using the Mesh Plug technique under local anaesthesia as a day surgery procedure. The mean age was 69 years. Concomitant diseases were present in 60(40%)patients. Local anaesthesia was used in 141 (94%) patients, general anaesthesia was used in 6 (4%) patients(who had failed local anaesthesia) and three (2%) patients had epidural anaesthesia . Operative time in minutes, hospital stay in days and the postoperative analgesic requirement were recorded. The postoperative pain was evaluated for the first eight hours using the Wong'Baker face scale. Results: The mean hospital stay postoperatively was 0.6 day (range 8 hours - 7 days), 138 patients were discharged after eight hours from the day surgery unit, while 12 patients stayed between 1-7 days. The mean operative time in minutes, including local anaesthesia infiltration was 36 minutes(range 30- 50 minutes). Local complications were reported in 39 men, 18 (12.76 %) had bruising, 18 (12.76°/o)had seroma and 3 (2.13%) had neuralgia. Neither infection nor recurrence were recorded during the period under review. Conclusion: Local anaesthesia and the Mesh Plug technique in inguinal hernia repair is safe and effective in such group of patients. Age and concomitant diseases should not be a contraindication to elective hernia repair. This policy should avoid the morbidity and mortality of emergency surgery.