title: Hernia repair in elderly patients under unmonitored local anaesthesia is feasible.
abstract: BACKGROUND
  There is a growing interest in the use of local anaesthesia for inguinal hernia repair. It certainly seems to be an acceptable alternative for the elderly. Supporting intravenous sedation, however, still requires monitoring, anaesthetic personnel and some preparations for the patient. Therefore we set up a feasibility study of hernia repair under local anaesthesia without intravenous sedation or monitoring in elderly patients.
  
  
  METHODS
  A total of 62 patients (aged 65 years or more) with unilateral inguinal hernia received a Mesh Plug Repair. Prospectively collected data included procedure-related complications and information on pain and quality of life as measured by Short Form 36.
  
  
  RESULTS
  No procedure-related complications were noted. Comparing the preoperative scores, the SF-36 on day 14 (n=61) did not differ significantly. After a median follow-up of ten months (n=54), significantly higher scores were found for scales of physical and emotional role and pain (all p<0.05). Twenty-two patients reported some form of pain (40.7%). 94.4% of the patients would recommend the procedure when asked.
  
  
  CONCLUSIONS
  The results of this study indicated that Mesh Plug Repair performed under unmonitored local anaesthesia with no intravenous sedation is a feasible alternative for elderly patients. It has advantages for the medical organization without disadvantages for the patient.
authors.affiliation: Department of General Surgery, Canisius-Wilhelmina Hospital, PO Box 9100, 6500 HB Nijmegen, The Netherlands. s.nienhuijs@hccnet.nl
authors.forename: S W
authors.initials: SW
authors.lastname: Nienhuijs
authors.forename: E E G
authors.initials: EE
authors.lastname: Remijn
authors.forename: C
authors.initials: C
authors.lastname: Rosman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative; D010147:Pain Measurement; D010149:Postoperative Pain; D011183:Postoperative Complications; D011788:Quality of Life; D013526:Surgical Mesh