Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct 15;50(4 Suppl 1):33-47.

Epidural Analgesia in Ventral Hernia Repair: An Analysis of 30-day Outcomes

Mark R Jones  1 , Ethan Y Brovman  1 , Amy E Wagenaar  1 , Samuel P Ang  1 , Edward E Whang  1 , Alan D Kaye  1 , Richard D Urman  1
Affiliations

Epidural Analgesia in Ventral Hernia Repair: An Analysis of 30-day Outcomes

Mark R Jones et al. Psychopharmacol Bull. .

Abstract

Background: Ventral hernia repair (VHR) is a common procedure associated with significant postoperative morbidity and prolonged hospital length of stay (LOS). The use of epidural analgesia in VHR has not been widely evaluated.

Purpose: To compare the outcomes of general anesthesia plus epidural analgesia (GA + EA) versus general anesthesia alone (GA) in patients undergoing ventral hernia repair.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify elective cases of VHR. Propensity score-matched analysis was used to compare outcomes in GA vs GA + EA groups. Cases receiving transverse abdominus plane blocks were excluded.

Results: A total of 9697 VHR cases were identified, resulting in two matched cohorts of 521 cases each. LOS was significantly longer in the GA + EA group (5.58 days) vs the GA group (5.20 days, p = 0.008). No other statistically significant differences in 30-day outcomes were observed between the matched cohorts.

Conclusion: Epidural analgesia in VHR is associated with statistically significant, but not clinically significant increase in LOS and may not yield any additional benefit in cases of isolated, elective VHR. Epidural analgesia may not be beneficial in this surgical population. Future studies should focus on alternative modes of analgesia to optimize pain control and outcomes for this procedure.

Keywords: anesthesia; complications; epidural; hernia; outcomes; regional; ventral.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Survival Probability (From 0 to 1) As a Function of Days Following Surgery (Up to 30 Days)
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Poulose BK, Shelton J, Phillips S, Moore D, Nealon W, Penson D, Beck W, Holzman MD. Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia. 2012;16:179–183. - PubMed
    1. Faylona JM. Evolution of ventral hernia repair. Asian J Endosc Surg. 2017;10:252–258. - PubMed
    1. Bisgaard T, Kehlet H, Bay-Nielsen MB, Iversen MG, Wara P, Rosenberg J, Friis-Andersen HF, Jorgensen LN. Nationwide study of early outcomes after incisional hernia repair. Br J Surg. 2009;96:1452–1457. - PubMed
    1. Majumder A, Fayezizadeh M, Neupane R, Elliott HL, Novitsky YW. Benefits of multimodal enhanced recovery pathway in patients undergoing open ventral hernia repair. J Am Coll Surg. 2016;222:1106–1115. - PubMed
    1. Carli F, Mayo N, Klubien K, Schricker T, Trudel J, Belliveau P. Epidural analgesia enhances functional exercise capacity and health-related quality of life after colonic surgery: results of a randomized trial. Anesthesiology. 2002;97:540–549. - PubMed

LinkOut - more resources