[Spinal anesthesia versus general anesthesia for inguinal hernia repair: propensity score analysis].

Background: Administrative database, used previously for control of cost, patient flow and invoicing, offer to researchers a large sample of patients representative of population providing interesting information's in the field of descriptive and analytic epidemiology with less cost.

Aim: To compare spinal to general anesthesia for inguinal hernia repair concerning a population extracted from administrative database after propensity matched analysis.

Methods: Prospective study concerning 4690 hospitalizations in Department B of General Surgery of Charles Nicolle hospital during a period of 18 months, between June 1st, 2008 and December 31st, 2009. A descriptive analysis followed by a comparison between spinal and general anesthesia according propensity matched analysis were performed. Résultats: 595 inguinal hernias were operated on. Mean age was 55±15.We mentioned a male predominance: 326 men (84.2%) and 61 women (15.8%). 137 patients had previous medical diseases(35.4%). 47(12.1%) patients were operated on in emergent situation on the other hand 340(87.9%) had elective surgery.264(68.2%) were ASA I, 110(28.4%) ASA II, 13(3.4%) ASA III. Post operative course were uneventful in 96.1% (372) and complicated in 11 patients (2.9%).Four deaths were observed (1%). Comparison before and after propensity matched analysis showed a statistical difference regarding postoperative stay and all hospital stay in favor of spinal anesthesia (p=0.007).

Conclusion: Postoperative stay is significantly shorter in the group of spinal anesthesia (p=0.007). A randomized clinical trial comparing spinal anesthesia to general anesthesia is needed.