Spinal versus General Anaesthesia in Surgery for Inguinodynia: a Randomized Controlled Trial

Background

Inguinodynia is a common complication following inguinal hernia repair, but may also be found after other types of (groin) surgery. If conservative treatments are to no avail, tailored remedial surgery may be considered. Remedial surgery includes a neurectomy and/or a (partial) meshectomy. Two retrospective studies in patients with chronic inguinodynia suggested that spinal anaesthesia is superior compared to general anaesthesia in terms of pain relief following these operations. This randomized controlled trial is designed to confirm the effect of the type of anaesthesia (spinal or general) on pain relief following remedial surgery for inguinodynia.


Methods

A total of 190 adult patients who suffer from unacceptable chronic (>3 months) inguinodynia, as subjectively judged by patients themselves, are included. Only patients scheduled to undergo remedial surgery including a neurectomy and/or a meshectomy by an open approach are considered for inclusion and randomized to spinal or general anaesthesia. Patients are excluded if pain is attributable to abdominal causes or if any contra-indications for either type of anaesthesia are present. Patients will be followed-up up to one year postoperatively. Primary outcome is the effect on the type of anaesthesia on pain relief. Secondary outcomes include patient satisfaction, quality of life, use of analgesics and (in)direct medical costs.

Spinal anaesthesia is superior compared to general anaesthesia in terms of pain relief following remedial surgery for chronic groin pain.

Postoperative after 1 week, 6 weeks, 3 months (short term)

Postoperative after 6 months and 1 year

spinal anaesthesia or general anaesthesia (during remedial surgery)