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Global anaesthesia practice using inguinal hernia surgery as a tracer condition : a secondary analysis of an international prospective cohort study

(2025) In Anaesthesia 80(11). p.1343-1351
Abstract
Introduction: Restoration of surgical capacity is essential to post-COVID-19 recovery. This study explored the use and safety of anaesthesia options for inguinal hernia surgery, a common tracer condition, to describe current global practice and highlight opportunities to build the capacity of health systems.

Methods: This is a secondary analysis of an international prospective cohort study of consecutive patients who underwent elective inguinal hernia surgery. We used a consensus process to define generalisable outcomes to measure patient selection, utilisation of hospital capacity and peri-operative safety in patients who received locoregional, spinal or general anaesthesia for their surgery.

Results: In total, 16,554... (More)
Introduction: Restoration of surgical capacity is essential to post-COVID-19 recovery. This study explored the use and safety of anaesthesia options for inguinal hernia surgery, a common tracer condition, to describe current global practice and highlight opportunities to build the capacity of health systems.

Methods: This is a secondary analysis of an international prospective cohort study of consecutive patients who underwent elective inguinal hernia surgery. We used a consensus process to define generalisable outcomes to measure patient selection, utilisation of hospital capacity and peri-operative safety in patients who received locoregional, spinal or general anaesthesia for their surgery.

Results: In total, 16,554 patients from 83 countries were included. Locoregional anaesthesia was performed in 1536 (9.2%) of patients, compared with 9165 (55.4%) who had general and 55,853 (35.4%) who had spinal anaesthesia. Patient selection outcomes were comparable across anaesthesia groups. As a measure of hospital capacity, adjusted day-case rates were higher for locoregional anaesthesia (OR 6.62, 95%CI 5.13-8.54, p < 0.001) but not for spinal anaesthesia (OR 0.97, 95%CI 0.84-1.12, p = 0.68) compared with general anaesthesia. Complications were lower in patients who underwent locoregional anaesthesia (OR = 0.67, 95%CI 0.52-0.87, p = 0.001) but not for spinal anaesthesia (OR = 0.90, 95%CI 0.77-1.05, p = 0.167) compared with general anaesthesia after risk adjustment.

Discussion: This study has filled knowledge gaps of anaesthesia practice in common surgeries across the world. Locoregional and spinal anaesthesia could be adopted as safe options to increase surgical volume when there is limited access to general anaesthesia.
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contributor
LU orcid
author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Anaesthesia
volume
80
issue
11
pages
1343 - 1351
publisher
Wiley-Blackwell
external identifiers
  • pmid:40923367
  • scopus:105018680319
ISSN
0003-2409
DOI
10.1111/anae.16686
language
English
LU publication?
yes
id
711d1b72-8e1d-437b-a90a-800653429d3f
date added to LUP
2026-08-14 08:54:18
date last changed
2026-08-15 04:01:28
@article{711d1b72-8e1d-437b-a90a-800653429d3f,
  abstract     = {{Introduction: Restoration of surgical capacity is essential to post-COVID-19 recovery. This study explored the use and safety of anaesthesia options for inguinal hernia surgery, a common tracer condition, to describe current global practice and highlight opportunities to build the capacity of health systems.<br/><br/>Methods: This is a secondary analysis of an international prospective cohort study of consecutive patients who underwent elective inguinal hernia surgery. We used a consensus process to define generalisable outcomes to measure patient selection, utilisation of hospital capacity and peri-operative safety in patients who received locoregional, spinal or general anaesthesia for their surgery.<br/><br/>Results: In total, 16,554 patients from 83 countries were included. Locoregional anaesthesia was performed in 1536 (9.2%) of patients, compared with 9165 (55.4%) who had general and 55,853 (35.4%) who had spinal anaesthesia. Patient selection outcomes were comparable across anaesthesia groups. As a measure of hospital capacity, adjusted day-case rates were higher for locoregional anaesthesia (OR 6.62, 95%CI 5.13-8.54, p &lt; 0.001) but not for spinal anaesthesia (OR 0.97, 95%CI 0.84-1.12, p = 0.68) compared with general anaesthesia. Complications were lower in patients who underwent locoregional anaesthesia (OR = 0.67, 95%CI 0.52-0.87, p = 0.001) but not for spinal anaesthesia (OR = 0.90, 95%CI 0.77-1.05, p = 0.167) compared with general anaesthesia after risk adjustment.<br/><br/>Discussion: This study has filled knowledge gaps of anaesthesia practice in common surgeries across the world. Locoregional and spinal anaesthesia could be adopted as safe options to increase surgical volume when there is limited access to general anaesthesia.<br/>}},
  issn         = {{0003-2409}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{1343--1351}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Anaesthesia}},
  title        = {{Global anaesthesia practice using inguinal hernia surgery as a tracer condition : a secondary analysis of an international prospective cohort study}},
  url          = {{http://dx.doi.org/10.1111/anae.16686}},
  doi          = {{10.1111/anae.16686}},
  volume       = {{80}},
  year         = {{2025}},
}