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Use of local anesthesia for inguinal hernia repair has decreased over time in the VA system.

Publication ,  Journal Article
Meier, J; Stevens, A; Berger, M; Hogan, TP; Reisch, J; Cullum, CM; Lee, SC; Skinner, CS; Zeh, H; Brown, CJ; Balentine, CJ
Published in: Hernia
August 2022

PURPOSE: In 2003, randomized trials demonstrated potentially improved outcomes when local instead of general anesthesia is used for inguinal hernia repair. Our study aimed to evaluate how the use of local anesthesia for this procedure changed over time following the publication of the trials' level 1 evidence. METHODS: We used the 1998-2018 Veterans Affairs Surgical Quality Improvement Program database to identify adults who underwent open, unilateral inguinal hernia repair under local or general anesthesia. Our primary outcome was the percentage of cases performed under local anesthesia. We used a time-series design to examine the trend and rate of change of the use of local anesthesia. RESULTS: We included 97,437 veterans, of which 22,333 (22.9%) had hernia surgery under local anesthesia. The median age of veterans receiving local anesthesia remained stable at 64-67 years over time. The use of local anesthesia decreased steadily, from 38.2% at the beginning year to 15.1% in the final year (P < 0.0001). The publication of results from randomized trials (in 2003) did not appear to increase the overall use or change the rate of decline in the use of local anesthesia. Overall, we found that the use of local anesthesia decreased by about 1.5% per year. CONCLUSION: The utilization of local anesthesia for inguinal hernia repair in the VA has steadily declined over the last 20 + years, despite data showing equivalence or superiority to general anesthesia. Future studies should explore barriers to the use of local anesthesia for hernia repair.

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Published In

Hernia

DOI

EISSN

1248-9204

Publication Date

August 2022

Volume

26

Issue

4

Start / End Page

1069 / 1075

Location

France

Related Subject Headings

  • Time Factors
  • Surgery
  • Middle Aged
  • Humans
  • Herniorrhaphy
  • Hernia, Inguinal
  • Anesthesia, Local
  • Anesthesia, General
  • Aged
  • Adult
 

Citation

APA
Chicago
ICMJE
MLA
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Meier, J., Stevens, A., Berger, M., Hogan, T. P., Reisch, J., Cullum, C. M., … Balentine, C. J. (2022). Use of local anesthesia for inguinal hernia repair has decreased over time in the VA system. Hernia, 26(4), 1069–1075. https://doi.org/10.1007/s10029-021-02532-3
Meier, J., A. Stevens, M. Berger, T. P. Hogan, J. Reisch, C. M. Cullum, S. C. Lee, et al. “Use of local anesthesia for inguinal hernia repair has decreased over time in the VA system.Hernia 26, no. 4 (August 2022): 1069–75. https://doi.org/10.1007/s10029-021-02532-3.
Meier J, Stevens A, Berger M, Hogan TP, Reisch J, Cullum CM, et al. Use of local anesthesia for inguinal hernia repair has decreased over time in the VA system. Hernia. 2022 Aug;26(4):1069–75.
Meier, J., et al. “Use of local anesthesia for inguinal hernia repair has decreased over time in the VA system.Hernia, vol. 26, no. 4, Aug. 2022, pp. 1069–75. Pubmed, doi:10.1007/s10029-021-02532-3.
Meier J, Stevens A, Berger M, Hogan TP, Reisch J, Cullum CM, Lee SC, Skinner CS, Zeh H, Brown CJ, Balentine CJ. Use of local anesthesia for inguinal hernia repair has decreased over time in the VA system. Hernia. 2022 Aug;26(4):1069–1075.
Journal cover image

Published In

Hernia

DOI

EISSN

1248-9204

Publication Date

August 2022

Volume

26

Issue

4

Start / End Page

1069 / 1075

Location

France

Related Subject Headings

  • Time Factors
  • Surgery
  • Middle Aged
  • Humans
  • Herniorrhaphy
  • Hernia, Inguinal
  • Anesthesia, Local
  • Anesthesia, General
  • Aged
  • Adult