Type of anaesthesia and patient acceptance in groin hernia repair: a multicentre randomised trial.
BACKGROUND
Groin hernia repair can be performed under general (GA), regional (RA), or local (LA) anaesthesia. This multicentre randomised trial evaluates patient acceptance, satisfaction, and quality of life with these three anaesthetic alternatives in hernia surgery.


METHODS
One hundred and thirty-eight patients at three hospitals were randomised to one of three groups, GA, RA, or LA. Upon discharge, they were asked to complete a specially designed questionnaire with items focusing on pain, discomfort, recovery, and overall satisfaction with the anaesthetic method used. The global quality-of-life instrument EuroQol was used for estimation of health perceived.


RESULTS
Significantly more patients in the LA group than in the RA group felt pain during surgery ( P<0.001). This pain was characterised as light or moderate and for the majority of LA patients was felt during infiltration of the anaesthetic agent. Postoperatively, patients in the LA group first felt pain significantly later than patients in the other two groups ( P=0.012) and significantly fewer LA patients consumed analgesics more than three times during the first postoperative day ( P=0.002). The results concerning nausea, vomiting, and time to first meal all favour LA. No difference was found among the three groups concerning overall satisfaction and quality of life.


CONCLUSIONS
In a general surgical setting, we found LA to be well tolerated and associated with significant advantages compared to GA and RA.
Nordin
P
P
Department of Surgery, Ostersund Hospital, 831 83, Ostersund, Sweden, par.nordin@jll.se
Hernell
H
H
Unosson
M
M
Gunnarsson
U
U
Nilsson
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000762:Anesthesia Recovery Period; D000765:Anesthesia, Conduction / Q000379:methods*; D000768:Anesthesia, General / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis*; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011336:Probability; D011788:Quality of Life; D018570:Risk Assessment