What anaesthesia is used for inguinal hernia surgery?

• Inguinal hernia repair can be performed by hernioplasty with surgical mesh or by herniorrhaphy, the former being the most commonly used.
• The approach to perform the inguinal hernia surgery can be either open or laparoscopic, the latter having advantages over the other.
• The inguinal hernia surgery requires anaesthesia, although it will depend on the patient and the doctor's opinion as to whether one type of anaesthesia is used or the other.

Before an inguinal hernia surgery, either by laparoscopy or by open surgery, the patient must first undergo a pre-operative examination, in order to be able to carry out the surgery as safely as possible and to know the type of anaesthesia that is appropriate for the patient according to his or her own characteristics.

Pre-operative consists of three tests that are performed for different reasons:

Complete blood test

A blood test will allow both the doctor and the anaesthetist to know the patient's health. It is mainly done to find out if there is any infection that could cause a complication during the intervention or cause problems during the surgery. 

Similarly, it is important to know if coagulation problems and other symptoms that may pose a risk to the patient appear in the blood test.

Electrocardiogram

In this case, the electrocardiogram will allow the surgeon performing the inguinal hernia operation as well as the anaesthetist assisting in the surgery to determine whether the patient has a heart healthy enough to withstand the anaesthesia.

Chest X-ray

This is an X-ray of the chest, allowing you to see the heart, lungs, airways, bones of the spine, blood vessels and chest. It can be used to see if there is any sign of infection, a heart or lung problem, or if the trachea is properly positioned, in case intubation is necessary during the use of general anaesthesia.

In most cases, after performing the preoperative tests, the anaesthesiologist will usually have a consultation with the patient to learn the results and review the patient's complete medical history.

In this way, he/she will be able to determine the type and amount of anaesthesia, general or regional, required for each specific patient.

It is also common that, in addition to reviewing the patient's medical history, a series of questions related to lifestyle habits and even a family history of allergies or heart problems are asked.

The anaesthesia used in inguinal hernia surgery, whether laparoscopic or open, is usually mainly general or regional, with local anaesthetic rarely used:

General anaesthesia

This type of anaesthesia puts the patient completely to sleep, which avoids any pain or discomfort during surgery. Likewise, this anaesthesia avoids any anxiety on the part of the patient. This type of anaesthesia is administered intravenously and can be combined with the inhalation of a gas through a mask.

The effect of the anaesthesia is progressive and the surgery will not start until the patient is completely asleep.

In the case of general anaesthesia, it is necessary to intubate the patient to help him/her breathe and avoid postoperative problems, which is one of the reasons why a chest x-ray is performed to determine that the trachea is correctly positioned.

Regional anaesthesia

Regional anaesthesia, being in this case epidural or spinal anaesthesia, puts the patient to sleep from the middle of the body to the feet. This allows the patient to remain awake during the surgery without feeling any pain, although to avoid any type of anxiety, the patient is usually sedated so that he/she does not feel anything and the surgery passes more quickly.

Regional anaesthesia consists of the introduction of an anaesthetic drug in the lumbar area, more specifically in the spinal canal, temporarily numbing the lower part of the body.

Of course, there are a number of things that need to be pointed out to them, for example:

• If you are or think you might be pregnant.
• Any prescription or over-the-counter medications, supplements, herbs, or anything else you're taking.
• If you are diabetic, it is also important for the surgeon to know, because although this need not be a problem for the operation, it is important to be very careful when it comes to recovery and wound healing.
• It is also important to indicate whether you have had any previous surgery, especially if any complications have occurred.

• Avoid taking medicines that make blood clotting difficult, such as aspirin, ibuprofen or others, for at least a week before surgery. It is important to discuss this with the surgeon so that he can give you instructions.
• It is also important to stop smoking before surgery (and in general), to promote clotting and postoperative recovery, as smoking hinders wound healing.

Once in the operating theatre, the patient will meet the surgeon, the anaesthesiologist and a member of the nursing team.

There, the anaesthesia will be administered, either intravenously in the case of general anaesthesia or by lumbar puncture in the case of spinal anaesthesia, and the patient will be monitored throughout the operation to check any possible alteration in their vital signs, as well as to regulate the anaesthesia to prevent them from waking up and suffering pain.

In the case of regional anaesthesia you may be given a sedative to reduce your anxiety and allow the surgery to pass quickly.

The surgery only begins when the anaesthesia has fully taken effect. If you want to know more about inguinal hernia surgery, click on the image below:

The main risks of anaesthesia are associated with age, associated diseases such as heart disease and diabetes, obesity or the consumption of substances such as tobacco or alcohol.

Reactions to medication, although this rarely occurs, as preoperative treatment is carried out to avoid this.

Respiratory problems, mainly associated with general anaesthesia but rare.

If you have further questions about the risks of anaesthesia, it is best to discuss them with the surgeon who is going to perform your surgical intervention.

It is normal to wake up tired and dizzy after the operation due to the anaesthesia drugs, and you may feel like vomiting, dry mouth, sore throat and cold.

In any case, there is no need to worry, as these symptoms do not always appear and pass after a couple of hours.

If you are thinking of undergoing an inguinal hernia surgery, request a free surgical assessment consultation by clicking below: