Skip to main content

Locoregional versus general anesthesia for open inguinal herniorrhaphy: a National Surgical Quality Improvement Program analysis.

Publication ,  Journal Article
Bhattacharya, SD; Vaslef, SN; Pappas, TN; Scarborough, JE
Published in: Am Surg
July 2012

Our objective was to study outcomes associated with open inguinal herniorrhaphy performed under locoregional (LR) versus general anesthesia (GA). National Surgical Quality Improvement Program (NSQIP) data from 2005 to 2009 was queried to capture patients undergoing initial unilateral inguinal herniorrhaphy. We excluded patients with incarcerated/strangulated hernia or those undergoing a concomitant procedure. Outcomes were anesthesia and operative times, postoperative admission, and 30-day morbidity. Using the entire NSQIP sample, forward stepwise multivariate regression analysis was used to compare outcomes between patients receiving LR versus GA after adjustment for patient demographics and comorbid diagnoses. Outcomes were also compared for a smaller subgroup of patients propensity-matched for receiving LR anesthesia. A total of 25,213 patients were analyzed (16,282 GA and 8,931 LR). Patients in the LR group had a higher incidence of comorbid illnesses and were more likely to have an American Society of Anesthesiologists classification ≥ 3. Multivariate analyses demonstrated that LR anesthetic is associated with shorter anesthetic and operative times and a lower hospital admission rate. Comparison using a propensity-matched cohort for undergoing LR anesthesia confirms that these patients had significantly shorter anesthesia (32 vs 38 min, P < 0.0001) and operative times (53.3 vs 57.2 min, P < 0.0001), as well as a significantly reduced rate of postoperative admission (5.9% vs 10.9%, P < 0.0001) and 30-day morbidity (0.9% vs 1.3%, P < 0.05). Our analysis of NSQIP suggests that, compared with general anesthesia, the locoregional technique is associated with shorter anesthesia and operative times, reduced need for postoperative hospital admission, and a small but significant reduction in postoperative morbidity.

Duke Scholars

Published In

Am Surg

EISSN

1555-9823

Publication Date

July 2012

Volume

78

Issue

7

Start / End Page

798 / 802

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Surgery
  • Quality Improvement
  • Postoperative Complications
  • Patient Readmission
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Logistic Models
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bhattacharya, S. D., Vaslef, S. N., Pappas, T. N., & Scarborough, J. E. (2012). Locoregional versus general anesthesia for open inguinal herniorrhaphy: a National Surgical Quality Improvement Program analysis. Am Surg, 78(7), 798–802.
Bhattacharya, Syamal D., Steven N. Vaslef, Theodore N. Pappas, and John E. Scarborough. “Locoregional versus general anesthesia for open inguinal herniorrhaphy: a National Surgical Quality Improvement Program analysis.Am Surg 78, no. 7 (July 2012): 798–802.
Bhattacharya SD, Vaslef SN, Pappas TN, Scarborough JE. Locoregional versus general anesthesia for open inguinal herniorrhaphy: a National Surgical Quality Improvement Program analysis. Am Surg. 2012 Jul;78(7):798–802.
Bhattacharya, Syamal D., et al. “Locoregional versus general anesthesia for open inguinal herniorrhaphy: a National Surgical Quality Improvement Program analysis.Am Surg, vol. 78, no. 7, July 2012, pp. 798–802.
Bhattacharya SD, Vaslef SN, Pappas TN, Scarborough JE. Locoregional versus general anesthesia for open inguinal herniorrhaphy: a National Surgical Quality Improvement Program analysis. Am Surg. 2012 Jul;78(7):798–802.

Published In

Am Surg

EISSN

1555-9823

Publication Date

July 2012

Volume

78

Issue

7

Start / End Page

798 / 802

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Surgery
  • Quality Improvement
  • Postoperative Complications
  • Patient Readmission
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Logistic Models