Recovery profiles and costs of anesthesia for outpatient unilateral inguinal herniorrhaphy

The use of an ilioinguinal-hypogastric nerve block (IHNB) as part of a moni tored anesthesia care (MAC) technique has been associated with a rapid reco very profile for outpatients undergoing inguinal herniorrhaphy procedures. This study was designed to compare the cost-effectiveness of an IHNB-MAC te chnique with standardized general and spinal anesthetics techniques for ing uinal herniorrhaphy in the ambulatory setting. We randomly assigned 81 cons enting outpatients to receive IHNB-MAC general anesthesia, or spinal anesth esia. We evaluated recovery times, 24-h postoperative side effects and asso ciated incremental costs. Compared with general and spinal anesthesia, pati ents receiving IHNB-MAC had the shortest time-to-home readiness (133 +/- 68 min vs 171 +/- 40 and 280 +/- 83 min), lowest pain score at discharge (15 +/- 14 mm vs 39 +/- 28 and 34 +/- 32 mm), and highest satisfaction at 24-h follow-up (75% vs 36% and 64%). The total anesthetic costs were also the le ast in the IHNB-MAC group ($132.73 +/- 33.80 vs $172.67 +/- 29.82 and $164. 97 +/- 31.03). We concluded that IHNB-MAC is the most cost-effective anesth etic technique for outpatients undergoing unilateral inguinal herniorrhaphy with respect to speed of recovery, patient comfort, and associated increme ntal costs.