Background: Inguinal hernia repair is a high-volume procedure frequently performed in Day Surgery settings. While local anesthesia is often considered the gold standard, its feasibility is limited in complex cases or due to patient refusal, necessitating alternatives like general (GA) or spinal anesthesia (SA). This study evaluates the impact of these techniques on acute pain, complications, and chronic postoperative inguinal pain (CPIP). Methods: A retrospective observational study was conducted on 73 adult patients undergoing unilateral Lichtenstein hernioplasty (GA = 24; SA = 49). Pain was assessed using the Numeric Rating Scale (NRS) at discharge (T0), 24 h (T1), 7 days (T2), and 180 days (T3). Postoperative complications, rescue analgesic consumption, and perceived time to recovery were recorded. A multivariable linear regression analysis was performed to adjust pain outcomes for age, sex, and ASA status. Results: GA patients reported significantly lower median NRS scores at T0, T1, and T2 in univariate analysis (p < 0.05). However, the multivariable model did not show statistical significance for anesthetic technique as an independent predictor. Constipation was the most frequent complication (35.6%), while nausea occurred only in the SA group (10.2%). Descriptive data showed a trend toward lower rescue analgesic needs and a faster perceived time to recovery in the GA group compared to SA. CPIP incidence was remarkably low (2.7%). Conclusions: GA is a valid alternative to SA in Day Surgery, showing a clinical trend toward better early pain control, lower analgesic consumption, and improved recovery perception, although multivariable analysis did not reach statistical significance.
Tozzi et al. (Tue,) studied this question.