Effect of anesthesia type on perioperative outcomes with a midurethral sling

Bhumy A. Davé*, Camaleigh Jaber, Alix Leader-Cramer, Nicole Higgins, Margaret G Mueller, Christina Lewicky Gaupp, Kimberly Sue Kenton

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Introduction and hypothesis: There is no consensus on the most appropriate type of anesthesia for placement of a midurethral sling. Our objective was to compare intra- and perioperative outcomes for this procedure performed under general anesthesia versus monitored anesthesia care. Methods: Retrospective cohort analysis of women undergoing outpatient placement of synthetic retropubic midurethral sling under general anesthesia (n = 141) or monitored anesthesia care (n = 84). Patients undergoing concomitant procedures were excluded. Primary outcome was operating room time. Secondary outcomes included surgical and recovery times, cost, discharge home with a catheter, and postoperative pain and/or nausea. Results: In the general anesthesia group, both operating room time (mean ± SD, 67.6 ± 13.3 min vs 56.9 ± 11.8 min, p < 0.001) and recovery room time (240.0 ± 69.8 min vs 190.1 ± 78.3 min, p < 0.001) were longer, whereas there was no difference in surgical time (30.0 ± 8.9 min vs 29.0 ± 9.7 min, p = 0.43). Cost was significantly higher in the general anesthesia group ($4,095 ± 715 vs $3,877 ± 777, p = 0.03). There was no difference in rates of bladder perforation (6.4 % vs 11.9 %, p = 0.33). Patients who underwent general anesthesia had higher rates of discharge with a catheter (27.0 % vs 15.8 %, p = 0.04). Conclusion: Monitored anesthesia care may offer significant benefits over general anesthesia in women undergoing retropubic midurethral sling, including shorter operating room and recovery times, lower costs, and less voiding dysfunction in the immediate postoperative period.

Original languageEnglish (US)
Pages (from-to)1327-1332
Number of pages6
JournalInternational Urogynecology Journal
Volume27
Issue number9
DOIs
StatePublished - Sep 1 2016

Keywords

  • Anesthesia
  • Economics
  • Operative time
  • Suburethral sling
  • Urinary retention

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Urology

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