Efficacy of general anesthesia as compared to spinal anesthesia for patients undergoing ventral abdominal hernia repair, a randomized controlled trial.

Abstract

Objective: To compare the use of general anesthesia with spinal anesthesia in patients undergoing ventral hernia repair. Study Design: Randomized Controlled Trial. Setting: Department of Anesthesia CMC Hospital @ SMBBMU Larkana. Period: January 2018 to December 2019. Material & Methods: We included patients above the age of 18 years, who presented with initial complaint of a ventral hernia, requiring surgical intervention. The exclusion criterion was all the patients with co-morbidities like malignancy, having a BMI score of greater than 35, having known allergies to anesthetic agents, and neurologic or neuromuscular diseases. A total of n=120 patients were included in the study and randomly divided into two groups. All the data including clinical parameters, drugs administered, and relevant side effects and complications were recorded in a pre-designed proforma. Results: The study population was n= 120 patients, the mean age was 45.5 +/- 15.5 years, there were n= 42 (35%) males and n= 78 (65%) females. There were no statistically significant differences among the two groups in terms of patient’s age, gender, blood pressures and heart rate. N= 54 (90%) of the patients belonging to the spinal anesthesia group had adequate anesthesia, the rest required administration of supplemental analgesic. None of the cases in the cohort had failure of the anesthetic technique. The postoperative visual analog scale scores at various time intervals (0, 2, 4 and 8 hours post procedure) were higher in the general anesthesia group versus spinal anesthesia group (p value of <0.05). Conclusion: Patients receiving spinal anesthesia had less incidence of post-operative nausea and required less analgesics, while patients receiving general anesthesia had more stable blood pressure profiles.