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Spinal anesthesia shows lower post-TKA complications, operating times
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In this study of the 30-day morbidity of patients who underwent total knee arthroplasty, the researchers found that patients who underwent the procedure under spinal anesthesia had lower operating times and postoperative complication rates over patients under general anesthesia.
“Patients undergoing total knee arthroplasty who were managed with general anesthesia had a small but significant increase in the risk of complications as compared with patients who were managed with spinal anesthesia; the difference was greatest for patients with multiple comorbidities,” John J. Callaghan, MD, and colleagues wrote in the study abstract. “Surgeons who perform knee arthroplasty may consider spinal anesthesia for patients with comorbidities.”
Using the American College of Surgeons National Surgical Quality Improvement Program database, Callaghan and colleagues identified 14,052 cases of total knee arthroplasty (TKA) between 2005 and 2010 where the studies identified patients under either spinal or general anesthesia, according to the abstract.
There was a significant difference between the short-term complication rates – spinal anesthesia patients had an 11.63% complication rate compared to a 15.28% complication rate in general anesthesia patients. Patients under spinal anesthesia also showed a lower rate of blood transfusions, superficial wound infections and overall complications over general anesthesia patients, but these results were of an unadjusted frequency.
The researchers noted that length of surgery was reduced from 100 minutes in the general anesthesia group to 96 minutes in the spinal anesthesia group, and that hospital length of stay was decreased from 3.77 days to 3.45 days, respectively.
Disclosure: The authors have no relevant financial disclosures.
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