Anesthetic type may not influence mental health after THA
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Key takeaways:
- The general anesthesia group and neuraxial anesthesia groups had improved postoperative mental health scores.
- The neuraxial anesthesia groups had higher mental health scores vs. the general anesthesia group.
Patients showed significant improvements in patient-reported mental health scores following total hip arthroplasty regardless of anesthetic type, according to data published in The Journal of Arthroplasty.
“Patient-reported mental health based on the [Patient-Reported Outcome Measurements Information Systems-10 (PROMIS-10)] Global Mental Health (GMH) scores improved significantly after THA without a discernable advantage attributable to any particular type of anesthesia,” the researchers wrote in the study. “Of interest, neuraxial anesthesia of any kind was more prevalent in patients who had higher baseline GMH scores; these differences in self-reported mental wellness persisted at follow-up, likely due to nonmedical determinants of care.”
Researchers prospectively collected GMH scores for 4,353 patients (mean age, 62 years) enrolled in the Pulmonary Embolism Prevention after Hip and Knee Replacement Trial at preoperative baseline and 1, 3 and 6 months after THA. Researchers categorized patients based on whether they received general anesthesia, neuraxial anesthesia or neuraxial anesthesia with peripheral block.
Researchers found GMH scores improved at 1, 3 and 6 months compared with baseline scores in all anesthetic groups. In addition, patients who received neuraxial anesthesia with or without peripheral block had higher baseline and follow-up GMH scores compared with patients who received general anesthesia alone.
“More robust analysis of patient anesthesia selection is likely needed to draw clear conclusions, but surgeons involved in creating clinical care pathways with standardized anesthetic approaches for total joint replacement patients should be aware of these variations in patient selection that may develop during the patient-anesthesiologist informed consenting discussion,” the researchers wrote. “Also, it is possible that the powerful mental health benefits of THA may overshadow more subtle differences in cognitive function which might be attributable to variations in anesthetic type.”
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