title: Long term outcome after lichtenstein hernia repair using general, locoregional or local anaesthesia.
abstract: BACKGROUND
  Chronic pain or discomfort after hernia surgery is nowadays a more challenging concern than recurrence. This study aimed to evaluate the long-term impact of local anaesthetic repair (LA) on pain, discomfort, paraesthesia and functional outcome after Lichtenstein hernia repair as compared to locoregional (LRA) and general anaesthesia (GA).
  
  
  METHODS
  patients with primary or recurrent inguinal hernia underwent Lichtenstein repair with a polypropylene mesh. All patients with a follow-up of at least three years were sent a detailed questionnaire and offered an outpatient visit. Kaplan-Meier estimates and Cox proportional hazard regressions were used to analyse the relationship between time to event variables and explanatory variables including anaesthesia type.
  
  
  RESULTS
  Between 1994 and 2006, in two cohorts, 330 patients answered the questionnaire: 100 under GA, 35 under LRA, and 195 under LA. This represented a response rate of 95, 94, and 98% respectively. Compared to GA and LRA, LA resulted in less long term pain, discomfort and paraesthesia. Moreover, resumption of social and professional activities was faster after LA. Recurrence rates were 1, 0, and 0.5% respectively.
  
  
  CONCLUSIONS
  After Lichtenstein inguinal hernia repair, LA results in beneficial effects beyond the immediate postoperative period.
authors.affiliation: Department of Surgery, St.-Elisabeth Ziekenhuis, Zottegem, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Verstraete
authors.forename: N
authors.initials: N
authors.lastname: Becaus
authors.forename: H
authors.initials: H
authors.lastname: Swannet
authors.forename: W
authors.initials: W
authors.lastname: Ceelen
authors.forename: L
authors.initials: L
authors.lastname: Duchateau
authors.forename: N
authors.initials: N
authors.lastname: Speybroeck
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D020911:Ketorolac Tromethamine / Q000008:administration & dosage; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D012008:Recurrence; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D020911:Ketorolac Tromethamine; D008012:Lidocaine; D002045:Bupivacaine