Anesthesia for Hernia Surgery

Kevin C. Petersen, M.D.

All forms of modern anesthesia are exceedingly safe. There are only a few minor differences in results. Serious complications are rare. There are differences in acute pain control. Short term memory loss is only seen in long surgeries in elderly patients. Long term side-effects are very rare. All forms of anesthesia are usually combined with some form of conscious sedation which relieves pain and anxiety and memory of pain and anxiety.  Pulmonary and cardiac disease are very important considerations. A patient's ability to cooperate is also an important consideration. There are many other things to consider. Your doctors will decide which is the best anesthesia for you. Please talk to your surgeon and anesthesiologist for more information

Types of Hernia Anesthesia

  • Local Anesthesia - Alone has very limited application in hernia surgery. It is usually combined with general anesthesia or some form of conscious sedation. Also long term anesthetic such as long lasting agents or continuous catheter infusion may be used.
  • Regional anesthesia- Numbs a larger area than local anesthesia. This provides better pain control than local anesthesia but is usually combined with some other form of anesthesia.
  • Spinal - Provides complete pain control but is usually combined with conscious sedation.
  • General - Provides complete pain control and control of movement but is usually combined conscious sedation. It has the advantage of controlling breathing so stopping breathing is a reduced risk. It may stress patients with pulmonary or cardiac disease.
  • General Anesthesia with endotracheal intubation - Will cause a sore throat in some patients. Most secure control of breathing.
  • General Anesthesia with laryngeal mask airway (LMA) - Controls breathing. Not a good choice for obese and other patients. Does not irritate the trachea.
  • Light Conscious Sedation - Eliminates anxiety. Lessens pain. Blocks memory of both. May require conversion to deep conscious sedation.
  • Deep Conscious Sedation - Can eliminate pain. Is difficult to control. May lead to respiratory arrest which will make conversion to general anesthesia necessary. When this happens in the middle of surgery it is dangerous.
  •  Nerve stabilizing agents - Gabapentin reduces the phenomena of acute and chronic central pain sensitization.
  • Other Agents- Intra operative Tylenol, Ketamine and many other agents.
Doctor Petersen's Hernia Surgery Anesthesia Protocol

Most patients wake up with no pain and ambulate immediately. Most patients need little or no narcotic pain medications after surgery.

  • Local Anesthesia, long acting, administered before first cut.
  • Regional Anesthesia, long acting
  • General Anesthesia with laryngeal mask airway (LMA)
  • Perioperative Gabapentin
Shouldice Hospital anesthesia procedure as observed by Dr. Petersen

Avoids patients' concerns about general anesthesia. Patients report satisfaction.

  • Light oral conscious sedation
  • Local anesthesia
Also See

Note - The medical literature is wanting and does not accurately reflect the experience of individual surgeons and anesthesiologists. This is because existing literature attempts to standardize series of large heterogenous groups of surgeons.

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