Local Anesthesia is Associated with Fewer Complications in Umbilical Hernia Repair in Frail Veterans

J Surg Res. 2021 Oct:266:88-95. doi: 10.1016/j.jss.2021.04.006. Epub 2021 May 11.

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.

Keywords: Frailty; General anesthesia; Local anesthesia; Umbilical hernia; Veterans.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, General / adverse effects*
  • Anesthesia, Local*
  • Databases, Factual
  • Elective Surgical Procedures / methods
  • Female
  • Frail Elderly
  • Frailty / complications*
  • Hernia, Umbilical / complications
  • Hernia, Umbilical / surgery*
  • Herniorrhaphy / methods*
  • Humans
  • Linear Models
  • Logistic Models
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Treatment Outcome
  • Veterans Health*
  • Young Adult