Background: Local anaesthetic hernia repair is thought to be safer for patients, causes less postoperative pain, costs less and is associated with a more rapid recovery for patients when compared with the same operation performed under general anaesthetic. The aim of this study was to compare patient outcome following local (LA) or general anaesthetic (GA) repair of a primary groin hernia. Methods: A randomized trial comparing patient outcome following LA or GA hernia repair. Outcome parameters measured included tests of vigilance, divided attention, sustained attention, memory, cognitive function, pain, return to normal activity and costs. Results: Two hundred and seventy-nine patients were randomized to LA or GA hernia repair, 276 of whom had an operation with 138 participants in each group. At 6, 24 and 72 h postoperatively there were no differences in vigilance or divided attention between the groups. Similarly, memory-sustained attention or cognitive function was not impaired in either group. Although physical activity was significantly (P = 0.0001) impaired at 24 h, this and return to usual social activities, 10 (7–14) days for LA versus 11 (7–14.5) days for GA, P = 0.5841, were similar in both groups. While patients in the LA group had significantly less pain on moving (P = 0.04) at 6 h, they were less likely 84 per cent versus 95 per cent for GA (P = 0.011), to recommend the same operation to someone else. General anaesthetic hernia repair cost £30.54 more than the same operation under LA. Conclusions: This study indicates that patient recovery is similar after LA or GA hernia repair.
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