Background: Inguinal hernia is one of the common surgical conditions, surgery being the absolute choice of treatment for cure. It is being done on inpatient basis since decades, because of the requirement of spinal or general anaesthesia.

Aims & Objectives: 1. to compare the efficacy of Lichtenstein tension free hernioplasty under local versus spinal anaesthesia for inguinal hernia. 2. To assess the overall outcome of hernia surgeries including intraoperative and postoperative complications, duration of hospital stay & cost effectiveness.

Materials and Methods: A prospective & comparative study was conducted on 60 patients presenting to Victoria Hospital, Bangalore with inguinal hernia during the period October 2013 to May 2015. Patients who fulfilled all criteria of inclusion were planned for surgery under 2 different groups.

Results: Total of 60 patients were included in the study with all 60 being male patients. The commonest group of presentation was between 31- 40 years (33.33%). Most of the patients presented with swelling in the groin alone about 60% and swelling with dragging type of pain of 40%. Indirect variety were common (76.66%) followed by direct (18.33%), recurrent (5%). Right sided hernia were common (63.33%) followed by left sided (36.33%). Risk factors associated with 43.33 % of increase intra abdominal pressure due to straining factors such as BPH, strenuous exercises, chronic constipation etc followed by smokers accounting for 40%. A comparative study of 30 cases each in group, SA group had more intra op and post op complications than LA group. Mean time taken for surgery under LA group was 36 +/- 9 minutes when compared to 51 +/-9 minutes, which is significant. LA group patients were ambulated early and there was a short hospital stay of 2-3 days in LA group when compared to SA group of 6-7 days. LA group was cost effective when compared to SA group.

Conclusion: Commonest age group affected being third decade of which most were right sided indirect type of hernia presenting mainly with the swelling in the groin. Both spinal and local anaesthesia can be used for LTF hernioplasty but spinal anaesthesia had high complication rates compared to local anaesthesia, considering short stay in hospital causing less economic burden to the patients.