- Dr Michael Schultz M.B.B.S, F.A.N.Z.C.A
- Dr May Lim M.B.B.S (Hons), F.A.N.Z.C.A
- Dr Robyn Maina M.B.B.S, F.A.N.Z.C.A
An anaesthetist’s perspective:
Why local anaesthesia with sedation is preferred over general anaesthesia
In the straight forward inguinal and other hernia repairs, the area of surgery is relatively small and local anaesthetic can be used to cover this entire area. The technique of local anaesthesia with sedation (L.A.- SED.) is preferable because although the patient is asleep for most of the procedure, this resembles more a natural sleep rather than full unconsciousness. Fewer drugs are used and so the residual effect is less.
The patient is able to wake up more clearly and is pain free because the local anaesthetic is still working. When the LA-SED begins to wear off, the patient is less drowsy and able to better manage pain relief. This implies that there is usually less overall pain and the reduced doses of analgesics mean that there are fewer side effects as well.
In addition, the technique of local anaesthesia with sedation means that complicated anaesthetic techniques such as paralysis of muscles and intubation (insertion of the tube into the trachea) together with mechanical ventilation are not necessary. In addition LA-SED is very suitable for the elderly and those with medical conditions for whom a major anaesthetic would be hazardous or technically difficult e.g. significant obesity, heart or lung disease.