Do race, gender, and source of payment impact on anesthetic technique for inguinal hernia repair?

Abstract

Study Objective To evaluate the potential differences in the type of anesthesia provided to patients of different race, gender, and source of payment undergoing inguinal hernia repair (IHR). Design Retrospective cohort study. Setting Ambulatory surgical centers/National Survey of Ambulatory Surgery. Patients 5810 patients older than 14 years who underwent IHR in an ambulatory surgical center. Interventions Inguinal hernia repair under different types of anesthesia. Measurements The association of race, gender, and source of payment with different types of anesthesia for IHR as determined by multivariate regression analysis. Results Significant discrepancies in the use of various anesthetics between patients of different race, gender, and source of payment were found. Patients identified as black and those of other minority groups were significantly more likely to receive general anesthesia compared with those identified as white (odds ratio [OR] 2.76, confidence interval [CI] 1.96-3.88 and OR 1.66, CI 1.14-2.42, respectively). Those identified as black were less likely to receive epidural anesthesia compared with their white counterparts (OR 0.36, CI 0.14-0.95). Women were less likely than men to undergo IHR with epidural anesthesia (OR 0.5, 95% CI 0.3-0.85). Conclusion Significant discrepancies in the use of various anesthetics for IHR between patients of different race, gender, and insurance status were found. Despite limitations inherent to secondary data analysis, the findings raise the possibility that nonmedical factors may influence anesthetic management.