Efficacy and Safety of 3 Different Anesthesia Techniques Used in Total Hip Arthroplasty

Abstract

BackgroundThis study compared the efficacy and safety of 3 different anesthesia techniques used in total hip arthroplasty (THA).Material/MethodsWe allocated 198 patients preparing to undertake THA into 3 groups: general anesthesia group (GA group, n=66), caudal epidural anesthesia group (CEA group, n=66), and spinal-epidural anesthesia group (SEA group, n=66). We compared postoperative adverse effects occurring in patients of the 3 anesthesia groups. The Visual Analog Scale (VAS) score, Minimum Mental State Examination (MMSE) score, and β-amyloid (Aβ) expression were calculated to determine the effects of different anesthesia on the postoperative pain and cognitive dysfunction of patients.ResultsThe CEA and SEA groups had lower rates of perioperative adverse effects than in the GA group. Patients in the GA group required significantly higher administration of analgesics after the surgery than those in CEA and SEA groups. Higher Aβ expression levels and VAS scores, as well as lower MMSE scores, were also seen in the GA group compared with the other 2 groups.ConclusionsCEA and SEA were more effective than GA in THA, and CEA seemed to be a better anesthesia technique than SEA.

Comparing the Effects of General Versus Regional Anesthesia on Postoperative Mortality in Total and Partial Hip Arthroplasty

“…Across several studies on this topic, the definition of regional anesthesia was not uniform, with some studies evaluating spinal anesthesia and others exploring epidural anesthesia, both of which are subtypes of regional anesthesia [12][13][14][15]. In addition, there have been conflicting results reported on the perioperative complications associated with regional anesthesia.…”

“…In general anesthesia, patients are in a complete state of unconsciousness [ 11 ]. The type of anesthesia utilized in hip arthroplasty patients is worth exploring further as it has important implications for the frequency and severity of perioperative complications given the differences in the mechanism of action and the rapidly increasing prevalence of hip arthroplasty [ 12 ]. Choice of anesthesia is important as well for primary care providers and cardiologists completing preoperative clearance for patients undergoing THA or PHA.…”

Effects of Intrathecal Bupivacaine and Bupivacaine Plus Fentanyl in Elderly Patients Undergoing Total Hip Arthroplasty

“…Spinal anesthesia can be used to low rates of perioperative adverse effects. [3][4][5] However, unstable hemodynamics following spinal anesthesia is well known, and can be problematic for these patients. To maintain stable hemodynamics and reduce the potential complications due to hypotension during spinal anesthesia, general clinical practice is to decrease the dosage of local anesthetic, increase fluid infusion and use various adrenergic agonists; however, this approach increases the unacceptable anaesthetic failure rate and perioperative risks in elder patients.…”

Perioperative Pain Management in Patients Undergoing Total Hip Arthroplasty: Where Do We Currently Stand?

“…This could be attributed not only to the considerable number of complications that may arise from GA but also to the better outcomes that RA has shown [11,25]. Also, a recent study conducted in 2017 has suggested that both SA and EA are associated with less postoperative pain and reduced need for analgesics [26]. On the other hand, a systematic review has indicated that even though neuraxial anesthesia (SA and EA) seems to be more effective, further studies are needed to prove its efficacy [27].…”