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Intra-operative pain and patient satisfaction during lichtenstein repair under local anesthesia versus spinal anesthesia: an open-label randomized controlled trial

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Abstract

Purpose

To compare pain during surgery among patients undergoing Lichtenstein inguinal hernia repair (LIHR) under local anaesthesia (LA) and spinal anaesthesia (SA).

Method

Patients were randomized to undergo LIHR under LA or SA. Both intra-operative and postoperative pain was measured by NRS (numerical rating scale). Postoperative pain was managed similarly in both groups using intravenous diclofenac and paracetamol. Postoperative recovery, time to discharge, and early complications were recorded. Postoperative pain was assessed at 2, 6 and 24 h from the time of skin incision. Patient satisfaction was recorded on 5-point Likert scale 24 h after surgery.

Results

Data of 30 patients of each group were analyzed. All patients successfully underwent operation using anaesthesia technique allocated. Median intra-operative pain was 0 (0,3) in SA and 2.5 (0,5) in LA group. In SA group, intra-operative pain did not exceed NRS 3, while in LA, pain greater than NRS 3 was reported in 30% patients. No patient required tramadol in either group during postoperative period. Minor postoperative complications were reported 9/30 (30%) in SA compared to 1/30 (3.33%) in LA group. The satisfaction rate was 67% in LA group, whereas 37% in SA group.

Conclusion

LA should be strongly considered for all patients with unilateral inguinal hernia undergoing open repair. In spite of a slightly more severe pain during surgery, patient satisfaction was higher using LA.

Trial registration

This study was conducted as a part of a postgraduate thesis research work. The protocol was submitted to the University of Delhi after approval of the IEC. Registration with the Clinical Trials Registry of India was not successfully done.

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Data availability

The raw data can be made available if requested.

Code availability

Not applicable.

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Funding

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Authors and Affiliations

  1. Department of General Surgery, UCMS and GTBH, University of Delhi, Delhi, India

    A. Verma

  2. Department of General Surgery, AIIMS Jodhpur, Jodhpur, Rajasthan, India

    N. Sharma

  3. Department of Anesthesiology, UCMS and GTBH, University of Delhi, Delhi, India

    G. Chilkoti

  4. Department of Surgical Oncology, Shri Guru Ram Rai Institute of Medical and Health Sciences and Shri Mahant Indresh Hospital, Dehradun, Uttarakhand, India

    P. K. Garg

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  1. A. Verma
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  2. N. Sharma
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  3. G. Chilkoti
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  4. P. K. Garg
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Contributions

All authors fulfil authorship criteria laid out by ICMJE.

Corresponding author

Correspondence to N. Sharma.

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Conflict of interest

All the authors declare that they have no conflict of interest.

Ethics approval

The study was approved by the IEC of UCMS, Delhi.

Human and animal rights

The study was approved by the IEC of the University College of Medical Sciences, Delhi and it adhered to all principles of ethics regarding research on human subjects. No animals were used or harmed during this study.

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All patients consented to participation in the study.

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Consent to publish anonymized results of the study was obtained from all participants.

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Verma, A., Sharma, N., Chilkoti, G. et al. Intra-operative pain and patient satisfaction during lichtenstein repair under local anesthesia versus spinal anesthesia: an open-label randomized controlled trial. Hernia 26, 1089–1094 (2022). https://doi.org/10.1007/s10029-022-02561-6

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  • DOI: https://doi.org/10.1007/s10029-022-02561-6

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