Welcome to the AHS 2020 ePoster Session. Please scroll down to view all of the submitted posters or press Control-F to search. To view the poster and its abstract, click on the poster image. Many posters also have a brief audio introduction which can be played by going to the bottom of the poster screen.
P007: USE OF SUGGAMADEX IN MINIMALLY INVASIVE INGUINAL HERNIA PATIENTS TO DECREASE INCIDENCE OF POSTOPERATIVE URINARY RETENTION
Christine Darcy, DO; Jake Sides, MD; Peter Santoro, MD; Christiana Care
Introduction: Post-operative urinary retention (POUR) is a common complication following minimally invasive inguinal hernia surgery and is reported in the literature to have an incidence of between 5.9 and 38%. Certain drugs have also been identified as risk factors for POUR, including perioperative anticholinergic agents, B-blockers, and sympathomimetics. Furthermore, prolonged anesthesia times and administration of more than 750 mL of crystalloid during the perioperative period was found to increase incidence by 2.3 times (Anes, 2009). Sugammadex, a modified gamma cyclodextrin which selectively binds neuromuscular-blocking agents Rocuronium, Vecuronium and Pancuronium in plasma resulting in rapid reversal, was approved by the FDA in 2015. With the introduction of an alternative to traditional reversal agents, commonly including Neostigmine plus/minus Glycopyrrolate, there is hope that the incidence of this perioperative occurrence can be minimized. The aim of this study is to evaluate rates of post-operative urinary retention in patients receiving traditional general anesthesia reversal agents versus those receiving Sugammadex after robotic assisted inguinal hernia repairs.
Methods: This study was a retrospective cohort study in a single community hospital. A total of 120 male patients were included in the study who underwent robotic assisted inguinal hernia repairs between 2018 - 2019. Patients who received Sugammadex (group S, n = 47) were compared to patients who received traditional anesthesia reversal agents (group T, n = 73). The primary outcome was the incidence of postoperative urinary retention requiring overnight hospitalization and the secondary outcome was length of stay in the hospital.
Results: Of the total 120 patients, 73 (60.8%) received traditional anesthesia reversal agents and 47 (39.1%) received Sugammadex. Of the patients in group T, 15 (25.9%) were admitted to a surgical floor for POUR and 58 (74.1%) were discharged home. Of the patients in group S who received Sugammadex, 4 (9.3%) were admitted to a surgical floor for POUR and 43 (91.7%) discharged home. A one-tailed z-score calculation of the two populations proportions yields a z-score of 1.7632 with a p-value = 0.0392, which is statistically significant at <0.05.
Conclusion: Based on literature review, robotic inguinal hernia surgery has the highest retention rate among surgical approaches for inguinal hernia repair at 18.1%, followed by laparoscopic surgery at 14.8%, and open at 6.3% (JACS 2019). In our study, we demonstrated that administration of Sugammadex after robotic assisted inguinal hernia repair resulted in statistically significant decrease in postoperative urinary retention.
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