Original article

Local versus general anaesthesia for open inguinal hernia repair: a retrospective cohort study of postoperative complications and patient-reported outcomes

Authors

• • Amir Tursunović
  • Surgery Clinic, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
• • Kenana Ljuca kenana.ljuca.medf@gmail.com Email Kenana Ljuca. (compose email, opens in email app.) Kenana Ljuca ORCID profile. (opens in new tab)
  • Department of Pharmacology, School of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
• • Emir Bećirović Emir Bećirović ORCID profile. (opens in new tab)
  • Clinic of Internal Medicine, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
• • Minela Bećirović Minela Bećirović ORCID profile. (opens in new tab)
  • Clinic of Internal Medicine, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
• • Nadina Ljuca
  • School of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
• • Jasminka Mujkanović
  • Surgery Clinic, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
• • Bahrudin Hadžiefendić
  • Department of Surgery, Eurofarm Centre Polyclinic Tuzla, Bosnia and Herzegovina

Abstract

Aim: To compare outcomes of elective open inguinal hernia repair under local anaesthesia (LA) and general anaesthesia (GA).

Methods: This retrospective cohort included 833 adults treated in Tuzla during 2017–2025. The primary outcome was any early adverse outcome within 30 days. Secondary outcomes included analgesic requirement, chronic groin pain, discomfort, dissatisfaction, and recurrence. Logistic regression adjusted for age, American Society of Anesthesiologists physical status, hernia characteristics, and technique. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were reported; Benjamini-Hochberg correction was applied to secondary outcomes.

Results: The LA group included 425 patients and the GA group 408. Postoperative analgesia was required in 338 (79.5%) and 110 (27.0%) patients, respectively (p<0.001). An early adverse outcome occurred in 79 (18.6%) and 35 (8.6%) patients (aOR 2.08, 95% CI 1.31–3.30; p = 0.002), mainly because of more haematomas with LA, 54 (12.7%) versus 20 (4.9%) (p < 0.001). Chronic groin pain did not differ after adjustment (aOR 1.26, 95% CI 0.81–1.96; p = 0.310). Dissatisfaction was higher with LA, 85 (20.8%) versus 40 (10.1%) (aOR 1.95, 95% CI 1.27–2.99; p = 0.002). Eight recurrences were recorded. Median follow-up was 14 months (interquartile range 12–18 months).

Conclusion: LA was associated with more early adverse outcomes and dissatisfaction than GA. Chronic pain did not differ after adjustment, and recurrence was similar. Selection bias and residual confounding should be considered.

Keywords: anaesthesia, hernia, inguinal, patient satisfaction, postoperative complications

How to Cite: Tursunović, A. , Ljuca, K. , Bećirović, E. , Bećirović, M. , Ljuca, N. , Mujkanović, J. & Hadžiefendić, B. (2026) “Local versus general anaesthesia for open inguinal hernia repair: a retrospective cohort study of postoperative complications and patient-reported outcomes”, Medicinski glasnik. 23(2). doi: https://doi.org/10.17392/medglas-2184-23-2