title: Lichtenstein hernia repair under different anaesthetic techniques with special emphasis on outcomes in older people.
abstract: BACKGROUND
  This study compared local (LA) and general anaesthesia (GA) for elective inguinal hernia repair with specific reference to older people (≥70 years).
  
  
  METHODS
  A total of 470 inguinal hernia repairs were compared for demographics, operating time, day case rates and complications. Subgroup analysis was performed to evaluate outcomes in <70 and >70 years.
  
  
  RESULTS
  A total of 288 LA and 182 GA repairs were performed. One hundred and forty-four (30.6%) patients were older than 70 years of which 80 (55%) were ASA (American Society of Anaesthesiologists) grades 3 and 4. Older (≥70 years) ASA grade 3 and 4 patients are more likely to undergo surgery under LA than GA (63% LA, 35% GA, P = 0.005) with higher day case rates of 81% LA, 33% GA, P = 0.0001). No significant difference in early complications, satisfaction rate and long-term recurrence rates were noted between the two groups.
  
  
  CONCLUSIONS
  LA inguinal hernia repair has significant short-term advantages and facilitates day surgery in older patients. LA should be the preferred option in the older patients.
authors.affiliation: Ninewells Hospital and Medical School, Dundee, UK. sanjay.pandanaboyana@nhs.net
authors.forename: Pandanaboyana
authors.initials: P
authors.lastname: Sanjay
authors.forename: Heather
authors.initials: H
authors.lastname: Leaver
authors.forename: Irshad
authors.initials: I
authors.lastname: Shaikh
authors.forename: Alan
authors.initials: A
authors.lastname: Woodward
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging; D000556:Ambulatory Surgical Procedures; D000768:Anesthesia, General / Q000009:adverse effects; D000772:Anesthesia, Local / Q000009:adverse effects; D016009:Chi-Square Distribution; D017558:Elective Surgical Procedures; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom