Comparison of spinal vs general anesthesia via laryngeal mask airway in inguinal hernia repair

Hypothesis: The use of laryngeal mask airway and propolol in inguinal hernia repair results in shorter operative and recovery room times. Design: Randomized control trial. Setting: University hospital. Patients: From May 2000 to March 2002, a convenience sample of 79 patients was invited to participate; 34 entered the study. Fifteen patients were randomized to subarachnoid block, and 18 patients were randomized to laryngeal mask air-way. No patients withdrew from the study because of adverse effects. All study subjects were followed up for 6 months. Intervention: General anesthesia via laryngeal mask airway or lidocaine subarachnoid block anesthesia for inguinal hernia repair. Main Outcome Measures: Operative and recovery room times; surgeon evaluation of the adequacy of the anesthetic technique; 36-Item Short-Form Health Survey scores before and after operation. Results: Total time from entry into the operating room to discharge home was slightly longer in the subarachnoid block group (285 vs 262 minutes; 95% confidence interval, 251-317 minutes) but this difference was not statistically or clinically significant. Patient satisfaction was high with both techniques; patient-reported outcomes were the same. Surgeons rated muscle relaxation and exposure better with the subarachnoid block. Conclusions: We found no differences between short-acting spinal anesthesia and general anesthesia via laryngeal mask airway with intravenous propofol in efficiency or in early or late outcomes after elective inguinal hernia repair. Surgeon and patient preferences appear to be the most important reasons for selecting an anesthetic technique for individual patients undergoing inguinal hernia repair.