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BACKGROUND: Approximately twenty million surgeries for primary or recurrent inguinal hernia are performed each year worldwide, and tension-free hernioplasty remains one of the most performed procedures in surgical departments. Several studies have demonstrated the superiority of the tension-free method free compared to classic repairs, in terms of recurrence rates, post-operative morbidity and patient satisfaction.METHODS: We retrospectively analyzed the medical records of all patients hospitalized from January 2010 to April 2011 diagnosed with inguinal hernia who underwent elective tension-free hernioplasty with an anterior approach under local anesthesia. After obtaining written consent, all surgical procedures were started under local anesthesia. All patients received "short-term" antibiotic prolapse with ceftazidime, usually administered one hour before surgery. Low molecular weight heparin was given to high-risk patients to prevent deep vein thrombosis. Patients were mobilized early after surgery and were generally discharged after a 6-24-hour observation period.RESULTS: In no case was there a switch from local to general anesthesia to conclude the procedure safely due to intraoperative discomfort or pain. There was no statistically significant correlations between pre-operative comorbidity, hernia type, operative time, and recurrence. Nor were there any correlations between immediate or late postoperative complications.CONCLUSIONS: The use of local anesthesia is indicated in recurrent inguinal hernia not only for its simplicity, safety and longer postoperative analgesia, but also and above all due to the absence of potential cardiovascular effects observed with general anesthesia.
Petracca et al. (Wed,) studied this question.