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International Urogynecology Journal

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01-01-2020 | Urinary Tract Infection | Original Article

Mode of anesthesia and major perioperative outcomes associated with vaginal surgery

Authors: Pamela E. Smith, Erinn M. Hade, Yubo Tan, Lopa K. Pandya, Andrew F. Hundley, Catherine O. Hudson

Published in: International Urogynecology Journal | Issue 1/2020

Abstract

Introduction and hypothesis

The primary aim was to compare the incidence of major perioperative complications in women undergoing vaginal reconstructive surgery with general, regional, and monitored anesthesia care using a national database. The secondary aim was to compare length of hospital stay, 30-day readmission rates, urinary tract infections, and reoperation rates between anesthesia types.

Materials and methods

The National Surgical Quality Improvement Program database was used to study women undergoing vaginal surgery for pelvic floor disorders from 2006 to 2015 via Current Procedural Terminology codes. Demographic and clinical variables were abstracted. The incidence of major perioperative complications was defined as the occurrence of any of the following within 30 days of surgery: death, surgical-site infection, pneumonia, venous thromboembolism, intensive care unit admission, stroke, transfusion, sepsis, and myocardial infarction. Regression analysis was used to estimate the relative risks (RR) associated with anesthesia type for each outcome.

Results

From the database, we gathered data on 37,426 women who underwent vaginal reconstructive surgery between 2006 and 2015; 87.2% (n = 32,623) underwent general, 6.9% (n = 2565) regional, and 5.9% (n = 2238) monitored anesthesia care. Major perioperative complications occurred in 560 women (1.5%). Relative to general anesthesia, the adjusted risk of major perioperative complications was not significantly different in those receiving monitored or regional anesthesia [monitored vs. general, adjusted RR 0.74, 95% confidence interval (CI) 0.45–1.20; regional vs. general, adjusted RR 1.23, 95% CI 0.92–1.65].

Discussion

Major perioperative complications in vaginal reconstructive surgery were uncommon, and no differences were observed between monitored, regional, and general anesthesia outcomes.

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Title: Mode of anesthesia and major perioperative outcomes associated with vaginal surgery
Authors: Pamela E. Smith
Erinn M. Hade
Yubo Tan
Lopa K. Pandya
Andrew F. Hundley
Catherine O. Hudson
Publication date: 01-01-2020
Publisher: Springer International Publishing
Keywords: Urinary Tract Infection
Vaginal Surgery
Hysterectomy
General Anesthesia
Published in: International Urogynecology Journal / Issue 1/2020
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-019-03908-x

At a glance: The STEP trials

Springer Medicine

Mode of anesthesia and major perioperative outcomes associated with vaginal surgery

Abstract

Introduction and hypothesis

Materials and methods

Results

Discussion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Materials and methods

Results

Discussion

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