COMPARASION BETWEEN GENERAL AND SPINAL ANESTHESIA DURING INGUINAL HERNIA SURGERY AT THE “8TH SEPTEMBER” GENERAL HOSPITAL IN SKOPJE, FOR THE PERIOD FROM JANUARY TO JUNE 2025

Abstract

Anesthesia represents a fundamental component of modern surgical practice, enabling safe and effective performance of operative interventions through the suppression of pain and the maintenance of optimal physiological conditions in the patient. Among the most frequently applied techniques are general anesthesia and spinal anesthesia, each with a specific mechanism of action, advantages, and limitations. General anesthesia induces a reversible state of unconsciousness through systemic administration of anesthetic agents, involving the entire organism and requiring airway control. In contrast, spinal anesthesia entails intrathecal administration of local anesthetics, resulting in regional sensory and motor blockade while preserving patient consciousness. This thesis presents a comparative analysis of general and spinal anesthesia with respect to indications, physiological effects, intraoperative management, and postoperative outcomes. Emphasis is placed on the safety profile, dynamics of postoperative recovery, hemodynamic stability, and the degree of patient satisfaction. The analysis demonstrates that general anesthesia is appropriate for extensive and prolonged surgical interventions, particularly those involving the upper part of the body, whereas spinal anesthesia represents a favorable option for procedures in the lower abdomen, pelvic region, and lower extremities due to faster postoperative recovery and a reduced risk of systemic complications. The subject of this paper is a comparison of spinal and general anesthesia as methods of anesthesia during hernia surgery in the GOB "8-mi Septemvri" in Skopje, for the period from January to June 2025. They were divided into two groups: patients operated on with general anesthesia and patients operated on with spinal anesthesia. In this study, 158 patients were included, of which 148 were male and 10 were female. Of the total number of patients, 75 were operated on with general anesthesia, and 83 with spinal. Patients operated on with spinal anesthesia (75) were compared with patients operated on with general anesthesia (83) in terms of the complications that occurred. The following postoperative complications were observed: urinary retention, gastrointestinal disturbances, non-specific and post-spinal headaches, pain, and respiratory complications. Postoperative nausea and vomiting and other observed complications were significantly more pronounced in patients operated on while under general anaesthesia. Additionally, complications were more frequent in smokers. Considering the results of this research, spinal anaesthesia is recommended for inguinal hernia in both younger and older patients. In conclusion, the choice between these two techniques should be individualized, taking into consideration the clinical characteristics of the patient, surgical requirements, and potential anesthetic risks, with the ultimate goal of achieving optimal perioperative outcomes