Giant hernia - Forum

[A Doctor]

Blood pressure drops (and probably also the usual practice of fluid loading before spinals) can be dangerous to patients with coronary artery disease. In these patients, locals are better.

[Hans]

Duration of action ideally suits it to a fairly short procedure like hernia repair. The main advantage of an epidural as I see it is the ability to top it up for post op analgesia or for a more prolonged operation. In my hospital we have no resident specialist anaesthetists and we therefore use spinal anaesthesia a lot for Caesars, hernias, prostatectomies and many other procedures "below the belt". I know you like local, but do you have anything against spinal?

[Old surgeon]

How many complications have you seen from GA, and this from a hospital with good access to highly trained anaesthetists? Any technique is only as safe as the practitioner of it but spinal anaesthetic can be used by folk with very limited anaesthetic experience - and is - with good success. Of course there are going to be problems, but if you are doing it for a patient with predominantly respiratory problems (as opposed to hypertension and cardiac ischaemia) and you lack a state of the art anaesthetic service (which appeared to be the case in the original post) then I stand by what I said.