[Day surgery of hernia].
BACKGROUND
Reduced economic resources have been a stimulus for increased day-case surgery, and an incentive for improving surgical technique and anaesthetic methods. In hernia surgery it is important to avoid recurrence and reoperation, which seems to be more easily achieved by the use of mesh prosthetics. For anaesthesia, costs may possibly be reduced by the use of spinal blockade instead of general anaesthesia, but also local infiltration anaesthesia is regaining popularity. We found it appropriate to evaluate and compare relevant factors associated with the use of these two anaesthetic techniques in our day-case surgery.


METHODS
Evaluation and analysis of the anaesthetic and postoperative notes on 413 adult patients with inguinal hernia operated in local anaesthesia and 121 patients operated in spinal anaesthesia.


RESULTS
Cardiovascular, respiratory and neurological problems were more frequent and more severe in the spinal than in the local anaesthesia group, whereas the need for extra analgesia and sedation perioperatively was higher in the local group. Time spent in the operating room was shorter, and early ambulation appeared to lead to less discomfort in the local anaesthesia group.


CONCLUSIONS
The results indicate that local infiltration is a safe, simple and effective technique when used for operations of abdominal hernias in adult patients, and can be recommended for day-case surgery of reducible inguinal hernias.
Vaagenes
P
P
Anestesiavdelingen, Sentralsykehuset i Akershus 1474 Nordbyhagen. per.vaagenes@ffi.no
Helgø
D
D
Helsingen
N
N
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000191:economics / Q000379:methods; D000772:Anesthesia, Local; D000775:Anesthesia, Spinal; D017046:Cost Savings; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D011183:Postoperative Complications / Q000175:diagnosis