Anaesthetics 2

Inguinal hernias can be repaired using a general (GA) or local (LA) anaesthetic.

Incisional hernias always require general anaesthetic

With general anaesthetic (GA) you are fast asleep, with local anaesthetic (LA) you are essentially awake – though a little bit drowsy or sedated, and the area of the hernia is made numb with a local anaesthetic injection (like the one your dentist uses).

Does local anaesthetic involve putting a needle in the back?

No – putting a needle in the back can be either a spinal or an epidural anaesthetic. It is not considered a good technique for hernia repair –

What does a local anaesthetic – LA – involve?

 It is very similar to the one your dentist uses. The technique I use involves a pinprick near the hip bone on the side of the hernia and then one or two more pinpricks near where the hernia is. The area goes numb within seconds. During the operation you would feel some pushing and be aware of touch – but no pain.

Why doesn’t everyone use local anesthetic?

 Not all surgeons are comfortable using LA. You have to be very proficient with the operation itself and you have to be patient and gentle with your technique. It is a little bit more demanding of the surgeon, but if done well it is probably better.  The specialist hernia centres tend to use local anaesthetic routinely.

What does a general anaesthetic – GA – involve?

 Usually just a pinprick in the back of the hand and then you fall asleep within seconds. The anaesthetic drugs nowadays are short-acting and rarely leave any unpleasant effects (nausea, vomiting).  Though you may be drowsy for a short while afterwards this soon wears off.  You should be able to go home the same day if you want.

 Is general anaesthetic safe?

Nowadays – yes, modern general anaesthesia is safe. 

Spinal and epidural anaethetic both make the body below the navel numb for a period time. It is a good method of pain relief for women giving birth but is not so good for having a hernia repair.  In some European countries it is used on all inguinal hernias.  However it can give rise to problems. Amongst other things there is a high likelihood being unable to pass urine afterwards. It is also not as safe as some surgeons would maintain.