Jennie Meier1, Miles Berger2, Timothy P Hogan3, Joan Reisch4, C Munro Cullum5, Simon C Lee4, Celette Sugg Skinner4, Herbert Zeh6, Cynthia J Brown7, Courtney J Balentine8. 1. North Texas VA Healthcare System, Department of Surgery, Dallas, Texas; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas; University of Texas Southwestern, Surgical Center for Outcomes, Implementation, and Novel Interventions (S-COIN), Dallas, Texas. Electronic address: jennie.meier@utsouthwestern.edu. 2. Department of Anesthesiology, Duke University, Durham, North Carolina. 3. Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas; University of Texas Southwestern, Surgical Center for Outcomes, Implementation, and Novel Interventions (S-COIN), Dallas, Texas; Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas; Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, US Department of Veterans Affairs, Bedford, Massachusetts. 4. Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas. 5. Division of Psychology, University of Texas Southwestern Medical Center, Dallas, Texas. 6. Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas. 7. Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama; Birmingham/Atlanta VA Geriatric, Research, Education, and Clinical Center, Birmingham, Alabama. 8. North Texas VA Healthcare System, Department of Surgery, Dallas, Texas; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas; University of Texas Southwestern, Surgical Center for Outcomes, Implementation, and Novel Interventions (S-COIN), Dallas, Texas.
Abstract
BACKGROUND: The optimal anesthesia modality for umbilical hernia repair is unclear. We hypothesized that using local rather than general anesthesia would be associated with improved outcomes, especially for frail patients. METHODS: We utilized the 1998-2018 Veterans Affairs Surgical Quality Improvement Program to identify patients who underwent elective, open umbilical hernia repair under general or local anesthesia. We used the Risk Analysis Index to measure frailty. Outcomes included complications and operative time. RESULTS: There were 4958 Veterans (13%) whose hernias were repaired under local anesthesia. Compared to general anesthesia, local was associated with a 12%-24% faster operative time for all patients, and an 86% lower (OR 0.14, 95%CI 0.03-0.72) complication rate for frail patients. CONCLUSIONS: Local anesthesia may reduce the operative time for all patients and complications for frail patients having umbilical hernia repair.
BACKGROUND: The optimal anesthesia modality for umbilical hernia repair is unclear. We hypothesized that using local rather than general anesthesia would be associated with improved outcomes, especially for frail patients. METHODS: We utilized the 1998-2018 Veterans Affairs Surgical Quality Improvement Program to identify patients who underwent elective, open umbilical hernia repair under general or local anesthesia. We used the Risk Analysis Index to measure frailty. Outcomes included complications and operative time. RESULTS: There were 4958 Veterans (13%) whose hernias were repaired under local anesthesia. Compared to general anesthesia, local was associated with a 12%-24% faster operative time for all patients, and an 86% lower (OR 0.14, 95%CI 0.03-0.72) complication rate for frail patients. CONCLUSIONS: Local anesthesia may reduce the operative time for all patients and complications for frail patients having umbilical hernia repair.
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