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Updated: Sep 15, 2026

Non-Intubated Video-Assisted Thoracoscopic Surgery
Published on: May 26, 2023
A comparison of epidural versus general anesthesia for outpatient endoscopic preperitoneal herniorrhaphy
A L Schuricht1, C S McCarthy, W L Wells
1Department of Surgery, Pennsylvania Hospital, Philadelphia 19107, USA.
Objectives:
To study the efficacy of epidural versus general anesthesia on length of stay, patient recovery and anesthetic-related complications in patients undergoing endoscopic preperitoneal herniorrhaphy.
Methods:
One hundred sixty-seven consecutive patients undergoing endoscopic preperitoneal herniorrhaphy from July, 1994, to August, 1995, were retrospectively studied. A total of 243 herniorrhaphies were performed. Four patients required conversion of epidural anesthesia to general anesthesia because of inadequate sensory blockade (67/71; 94% success rate). One-hundred-forty-eight patients were available for review. Sixty-seven patients underwent successful epidural anesthesia during the case, while 81 patients were managed with general anesthesia.
Results:
Thirty patients (37%) receiving general anesthesia required interventions for nausea compared to only six patients (9.0%) in the epidural anesthesia group (p < 0.001). Thirty patients (37%) in the general anesthesia group required intervention because of complaints of pain, compared to 13 (19.4%) in the epidural group (p < 0.05). There were no differences between the two groups for length of stay in OR, PACU, or total hospital times.
Conclusions:
The use of epidural anesthesia during the performance of endoscopic preperitoneal herniorrhaphy was associated with a decrease in the incidence of postoperative pain and nausea. The technique was successful in 94% of the cases in which it was used. Epidural anesthesia is recommended as an effective alternative to general anesthesia for the performance of outpatient endoscopic preperitoneal herniorrhaphy.
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