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Use of neuraxial, general anesthesia found dependent on patient, provider characteristics
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Patient and provider characteristics were associated with the use of neuraxial anesthesia or general anesthesia for total hip arthroplasty, according to results.
Researchers stratified 107,490 total hip arthroplasties from the National Anesthesia Clinical Outcomes Registry (THAs) into a general anesthesia group (68.3%) or neuraxial anesthesia group (31.7%) and compared patient, provider and facility characteristics.
Results showed more patients in the neuraxial group were classified as American Society of Anesthesiologists (ASA) I or II vs. the general anesthesia group. Researchers found a decreased mean case duration among THAs performed with neuraxial anesthesia as the primary anesthetic, with a difference of approximately 11 minutes compared with general anesthesia. Board-certified anesthesiologists and the presence of an anesthesiology resident during the case were more common in the neuraxial group, according to results. However, the general anesthesia group was more likely to have a certified registered nurse anesthetist present vs. the neuraxial group.
Logistic regression analysis showed patients with greater comorbidities and cases of longer duration had decreased odds of receiving neuraxial anesthesia and university hospitals had the lowest odds for using neuraxial anesthesia as the primary anesthetic, while the presence of an anesthesia resident showed increased odds for neuraxial anesthesia. Researchers also found, after controlling for ASA physical status class and facility type, neuraxial anesthesia utilization was associated with the presence of a board-certified anesthesiologist. Decreased odds for extended post-anesthesia care unit stay, decreased inadequate pain control and decreased postoperative nausea/vomiting, as well as increased odds for case delays, were associated with neuraxial anesthesia, according to results. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.
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