期刊
JOURNAL OF SURGICAL RESEARCH
卷 266, 期 -, 页码 366-372出版社
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.jss.2021.04.026
关键词
Veterans; Racial disparity; Ethnic disparity; Local anesthesia; Inguinal hernia repair
类别
资金
- GEMSSTAR grant from the National Institute of Aging [1R03AG056330]
- VA Rehabilitation RD Merit Award [1 I01 RX001995]
- National Institutes of Health Beeson [K76AG057022]
- National Institutes of Health [P30AG028716]
- Duke Anesthesiology Department
The study found that African American and Hispanic patients were less likely to receive local anesthesia for inguinal hernia repair compared to Caucasian patients, despite the potential benefits of local anesthesia for enhanced recovery and fewer postoperative complications. Addressing this disparity requires further investigation into the factors influencing the choice of anesthesia modality for hernia repair.
Background: Many studies have identified racial disparities in healthcare, but few have described disparities in the use of anesthesia modalities. We examined racial disparities in the use of local versus general anesthesia for inguinal hernia repair. We hypothesized that African American and Hispanic patients would be less likely than Caucasians to receive local anesthesia for inguinal hernia repair. Materials and methods: We included 78,766 patients aged > 18 years in the Veterans Affairs Surgical Quality Improvement Program database who underwent elective, unilateral, open inguinal hernia repair under general or local anesthesia from 1998-2018. We used multiple logistic regression to compare use of local versus general anesthesia and 30-day postoperative complications by race/ethnicity. Results: In total, 17,892 (23%) patients received local anesthesia. Caucasian patients more frequently received local anesthesia (15,009; 24%), compared to African Americans (2353; 17%) and Hispanics (530; 19%), P < 0.05. After adjusting for covariates, we found that African Americans (OR 0.82, 95% CI 0.77-0.86) and Hispanics (OR 0.77, 95% CI 0.69-0.87) were signif-icantly less likely to have hernia surgery under local anesthesia compared to Caucasians. Additionally, local anesthesia was associated with fewer postoperative complications for African American patients (OR 0.46, 95% CI 0.27-0.77). Conclusions: Although local anesthesia was associated with enhanced recovery for African American patients, they were less likely to have inguinal hernias repaired under local than Caucasians. Addressing this disparity requires a better understanding of how surgeons, anesthesiologists, and patient-related factors may affect the choice of anesthesia modal-ity for hernia repair. (c) 2021 Elsevier Inc. All rights reserved.
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