Tolerability and Outcome of Inguinal Hernia Repair under Local Anesthesia among elderly male patients high risk for General or Regional Anesthesia

Background: Surgical repair of inguinal hernias in elderly population is challenging as these pts may have associated co-morbid conditions which make them high risk for general or regional anesthesia. Aim: To find out tolerability and outcome of operating inguinal hernia among elderly population who are high risk for general or regional anesthesia. Methods: One hundred elderly patients with inguinal hernia who were high risk for general or regional anesthesia were included in the study from January 2014 to January 2016. Associated co-morbid conditions were labeled. All the patients received treatment with prosthetic mesh repair under local anesthesia. The patients were evaluated for tolerability and outcome of local anesthesia. Results: The mean age was 78.2±9.64 years. Following were co-morbid conditions: hypertension in 56(56%) patients, ischemic heart disease in 44(44%) patients, diabetes mellitus in 22(22%) patients and chronic obstructive pulmonary disease in 17(17%) patients. Local anesthesia was tolerable in 95(95%) patients. Pain during procedure was seen in 3(3%) patients, while nausea/vomiting and headache in 1(1%) patient each. Postoperatively, pain was seen among 4(4%) patients, urinary retention in 1(1%), inguinodynia in 1(1%) patient, and scrotal hematoma in 2(2%) patients. Conclusion: Our experience shows that prosthetic repair for inguinal hernia among elderly patients who are high risk for general or spinal anesthesia is well tolerated and has favorable outcome. In future it may erase the wait and watch strategy in such patients.