Comparison of Local Versus General Anesthesia in Open Inguinal Hernioplasty: A Prospective Study on Postoperative Outcomes and Cost-Effectiveness

Abstract

Objective: This study evaluates whether performing open inguinal hernia repair under local anesthesia with same-day discharge is comparable to general anesthesia with inpatient admission, with respect to postoperative outcomes, recovery time, and healthcare costs. Materials and Methods: This prospective cohort study was conducted at Siriraj Hospital and included 30 adults undergoing unilateral open inguinal hernioplasty. Patients were allocated to either local anesthesia with same-day discharge (n=15) or general anesthesia with inpatient admission (n=15). Postoperative pain, recovery time, operative efficiency, complications, and total hospital costs were assessed. Results: Postoperative pain at rest at 8 and 24 hours was lower in the LA group compared with the GA group (1.93±1.10 vs 2.53±1.55 p=0.233, 0.87±0.83 vs 1.80±1.65 p=0.032). Patients in the LA group resumed normal activities significantly earlier, and total hospital costs were significantly lower (1.00+0.54 vs 1.40+0.51 p = 0.022, 13,453 THB vs. 41,226 THB; p<0.001). Operative time, theater time, complications, and patient demographics (age, BMI, ASA classification) were comparable between groups. Conclusions: Open inguinal hernioplasty under local anesthesia in a day-surgery setting demonstrated clinical outcomes comparable to those of general anesthesia with inpatient admission. Additionally, this approach was associated with faster functional recovery and significantly reduced hospital costs. Local anesthesia represents a safe, efficient, and cost-effective alternative for appropriately selected patients.