Local Anesthesia in Inguinal Hernia: Indications and Techniques

Large epidemiologic and consecutive series and several retrospective and randomized controlled trials have shown the superiority of local anesthesia over general and regional anesthesias for primary inguinal hernia repair in terms of less postoperative pain, less anesthesia-related complaints, less micturition difficulties, faster discharge, and faster short-term recovery. Despite the advantages in using local anesthesia, inguinal hernia repair under this kind of anesthesia is not a common procedure. Intraoperative pain seems to be the most common reason for dissatisfaction with local anesthesia. Local anesthesia should not be considered as just a surgical step performed by surgeon, but it is quite a philosophy, like a methodology to approach the patient, in which the patient is the center of the attention and all the people in the operating theater work with the aim to reduce the patient perception of undergoing surgery, not only the pain feeling. Surgical technique must be necessarily flawless. Here some tips and tricks for performing a good local anesthesia are suggested.