Choice of Neuraxial over General Anesthesia for Incisional Hernia Repair: A Case Report

Background: Incisional hernias usually developed from the former postoperative scar. Surgery is often necessary to push the protruding tissue back in place, remove any scar, and adhere to a surgical mesh to prevent recurrence. Open ventral repair is often performed under general anaesthesia but can also be done under neuraxial anesthesia. Case Report: We report a case of a 59-year-old female, ASA 2 for Obesity (BMI 31 kg/m²), Hypertension, Type 2 Diabetes Mellitus non-insulin requiring, and Bronchial asthma not in acute exacerbation, who presented with a 9-month history of periumbilical bulge more prominent upon standing up and straining. Patient underwent mesh repair of incisional under neuraxial anaesthesia due to associated comorbidities. Conclusion: While most would do the case under general anaesthesia, neuraxial anesthesia offers a more reasonable anesthetic plan, especially in patients presenting with different comorbidities. Novel Aspects: Neuraxial anesthesia for incisional hernia repair is feasible and offers less airway manipulation and opioid requirements. Avoiding intubation and muscle relaxant in the setting of morbidly obese and asthmatic patients allow better and enhanced postoperative respiratory recovery with optimal pain control.