Skip to main content
Journal cover image

Using local rather than general anesthesia for inguinal hernia repair may significantly reduce complications for frail Veterans.

Publication ,  Journal Article
Meier, J; Berger, M; Hogan, T; Reisch, J; Zeh, H; Cullum, CM; Lee, SC; Skinner, CS; Brown, CJ; Balentine, CJ
Published in: Am J Surg
September 2021

BACKGROUND: Frailty predisposes patients to poor postoperative outcomes. We evaluated whether using local rather than general anesthesia for hernia repair could mitigate effects of frailty. METHODS: We used the Risk Analysis Index (RAI) to identify 8,038 frail patients in the 1998-2018 Veterans Affairs Surgical Quality Improvement Program database who underwent elective, open unilateral inguinal hernia repair under local or general anesthesia. Our outcome of interest was the incidence of postoperative complications. RESULTS: In total, 5,188 (65%) patients received general anesthesia and 2,850 (35%) received local. Local anesthesia was associated with a 48% reduction in complications (OR 0.52, 95%CI 0.38-0.72). Among the frailest patients (RAI≥70), predicted probability of a postoperative complication ranged from 22 to 33% with general anesthesia, compared to 13-21% with local. CONCLUSIONS: Local anesthesia was associated with a ∼50% reduction in postoperative complications in frail Veterans. Given the paucity of interventions for frail patients, there is an urgent need for a randomized trial comparing effects of anesthesia modality on postoperative complications in this vulnerable population.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Am J Surg

DOI

EISSN

1879-1883

Publication Date

September 2021

Volume

222

Issue

3

Start / End Page

619 / 624

Location

United States

Related Subject Headings

  • Veterans
  • Surgery
  • Postoperative Complications
  • Male
  • Incidence
  • Humans
  • Herniorrhaphy
  • Hernia, Inguinal
  • Frailty
  • Frail Elderly
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Meier, J., Berger, M., Hogan, T., Reisch, J., Zeh, H., Cullum, C. M., … Balentine, C. J. (2021). Using local rather than general anesthesia for inguinal hernia repair may significantly reduce complications for frail Veterans. Am J Surg, 222(3), 619–624. https://doi.org/10.1016/j.amjsurg.2021.01.026
Meier, Jennie, Miles Berger, Timothy Hogan, Joan Reisch, Herbert Zeh, C Munro Cullum, Simon C. Lee, Celette Sugg Skinner, Cynthia J. Brown, and Courtney J. Balentine. “Using local rather than general anesthesia for inguinal hernia repair may significantly reduce complications for frail Veterans.Am J Surg 222, no. 3 (September 2021): 619–24. https://doi.org/10.1016/j.amjsurg.2021.01.026.
Meier J, Berger M, Hogan T, Reisch J, Zeh H, Cullum CM, et al. Using local rather than general anesthesia for inguinal hernia repair may significantly reduce complications for frail Veterans. Am J Surg. 2021 Sep;222(3):619–24.
Meier, Jennie, et al. “Using local rather than general anesthesia for inguinal hernia repair may significantly reduce complications for frail Veterans.Am J Surg, vol. 222, no. 3, Sept. 2021, pp. 619–24. Pubmed, doi:10.1016/j.amjsurg.2021.01.026.
Meier J, Berger M, Hogan T, Reisch J, Zeh H, Cullum CM, Lee SC, Skinner CS, Brown CJ, Balentine CJ. Using local rather than general anesthesia for inguinal hernia repair may significantly reduce complications for frail Veterans. Am J Surg. 2021 Sep;222(3):619–624.
Journal cover image

Published In

Am J Surg

DOI

EISSN

1879-1883

Publication Date

September 2021

Volume

222

Issue

3

Start / End Page

619 / 624

Location

United States

Related Subject Headings

  • Veterans
  • Surgery
  • Postoperative Complications
  • Male
  • Incidence
  • Humans
  • Herniorrhaphy
  • Hernia, Inguinal
  • Frailty
  • Frail Elderly