A comparative study of spinal anaesthesia versus epidural anaesthesia for inguinal hernioplasty

Introduction: Inguinal hernia repair is normally implemented under spinal anaesthesia. However, epidural anaesthesia procedure offers constant hemodynamic with early ambulation and less urinary retention, less frequency of nausea and vomiting. We compared efficacy, feasibility and safety of ilioinguinal nerve block for inguinal hernia repair with spinal anaesthesia versus epidural anaesthesia. Material and methods: Hundred adult male patients scheduled for elective inguinal hernia repair were randomized into two groups to receive either spinal anaesthesia or epidural anaesthesia. The total time to perform anaesthetic procedures, time of onset, hemodynamic variations, supplemental sedation, intraoperative fluid requirement, duration of postoperative analgesia and ambulation were compared in both groups. Continuous data are presented as mean±S.D. Unpaired t-test and paired t-test were applied for intergroup and intragroup comparisons respectively. P< 0.05 was taken as significant. Results: Duration to perform the procedure was significantly longer with epidural than spinal block (7.95±0.41 Vs 3.73±0.67 minutes). Intraoperative fluid requirement was statistically higher in Spinal than Epidural (1580±190.1 ml vs 1021.33±77.16 ml) (p< 0.0001). Duration of Surgery was significantly shorter in Spinal as compared to Epidural (85.17±7.82 vs 101.00±10.20 mins.) (p=0.019). Systolic and mean blood pressure showed statistically significant reduction in Spinal as compared to Epidural (19(40%) vs 3(6%)) (p< 0.001). Duration of ambulation was significantly shorter in Epidural as compared to Spinal (3.95±2.57 vs 9.58±0.82 hours) (p< 0.001). Conclusion: Epidural anaesthesia can be a safe alternative to spinal anaesthesia for elective inguinal hernia repair.