Comparison of General and Spinal Anesthesia in Patients Undergoing Open Abdominal Hernia Repair in Terms of Post-Operative Pain

Abstract

Background and Objectives: Abdominal hernioplasty is a very common intervention that can be performed under general or spinal anesthesia. We compared general and spinal anesthesia in patients undergoing open abdominal hernia repair on elective basis. Study Design: Randomized control study. Place of Study:  Allied Hospital Faisalabad. Period: September 2017 to December 2017. Methodology: Forty (40) adults received either General Anesthesia with succinylcholine, propofol, nelbuphine and atrarcurium (group A, n=20) or spinal anesthesia (L3–L4) with bupivacaine 0.5% 10mg (group B, n=20). Then the Hemodynamic data (blood pressure, pulse), pain scores, time to first analgesic and side-effects were recorded of the patients. Results: Among the patients, hernia was supraumbilical in 6, umbilical in 7 and infraumbilical in 7 patients of group A and in 6, 6 and 8 in group B patients, respectively, p value >0.05. Maximum decrease of systolic blood pressure was 10±6 in group A and 21±6% in group B, p value <0.05 and of heart rate 11±5 and 17±7%, p value >0.05, respectively. Pain scores at 0, 2, 4 and 8 hours after surgery were: 4 (2–6), 5 (2–7), 5 (1–6) and 4 (2–6) in group A and 0, 0, 0 (0–2) and 1 (0–3) in group B, respectively, p value <0.05. Pain scores at 12 and 24 hours were 4 (1–5) and 3 (0–4) in group A and 2 (0–4) and 1 (0–3) in group B, respectively, p value >0.05. Time to first analgesic was 28±10 in group A and 580±138 min in group B, p value <0.001. 7 (35%) of the patients in group A and 1 (5%) in group B patients had post-operative nausea and vomiting, p value <0.05. Conclusion: Patients undergoing open ventral hernia repair and received general anesthesia were more stable in terms of blood pressure and heart rate but the patients who received spinal anesthesia had less postoperative pain and less post-operative nausea and vomiting.