Spinal Anesthesia a preferred option to GA For Patients of Revision THA, Study Finds

Researchers have found in a new study that Spinal Anesthesia Is A Favourable Alternative To General Anesthesia For Patients Undergoing Revision Total Hip Arthroplasty(THA),

Revision Total Hip Arthroplasty (THA) is performed to repair a hip prosthesis that may have been damaged because of an infection, or due to normal wear and tear. Revision Arthroplasty is a corrective procedure so that the hip can function normally again.

The new study has been published in the Journal of American Academy of Orthopaedic Surgeons.

Spinal anesthesia has been previously shown to offer improved patient outcomes compared to general anesthesia during revision total knee arthroplasty. Therefore, researchers from the Department of Orthopaedic Surgery at the Harvard Medical School, Boston, aimed to evaluate the potential differences in the perioperartive and postoperative outcomes associated with Revision Total Hip Arthroplasty (THA), between Spinal and General Anesthesia.

A total of 2,656 patients who underwent revision THA were included in the study. Propensity-score-adjusted multivariate logistic regression analyses were applied to control for intergroup variability and evaluate the differences in outcomes and complications with the type of Anesthesia.

The study showed some interesting results:

i) Patients administered with general anesthesia had a significantly longer procedure time (174.8 versus 161.3 minutes)

ii) Patients administered with general anesthesia had a higher intra-operative (402.6 versus 305.5 mL) and peri-operative blood loss (1802.2 versus 1,684.2 mL).

iii) Patients administered with general anesthesia had greater odds for in-hospital complications (odds ratio, 4.51) and increased duration of stay (odds ratio, 2.45).

"The study shows that patients who received spinal anesthesia for revision THA exhibited notable reduction in surgical time, perioperative blood loss, and complications compared with patients who received general anesthesia, suggesting that spinal anesthesia is a viable alternative to general anesthesia in revision THA," the research team concluded.

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The study titled, "Outcome of Spinal Versus General Anesthesia in Revision Total Hip Arthroplasty: A Propensity Score-Matched Cohort Analysis," is published in the Journal of American Academy of Orthopaedic Surgeons.

DOI: 10.5435/JAAOS-D-20-0079