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. |
