Comparative effectiveness of neuraxial versus general anesthesia in total joint replacement surgery: an updated retrospective analysis using more recent data
Authors' conclusion
These findings re-confirm our study group's decade-old study using more recent data and offer additional evidence toward the sustained benefit of neuraxial anesthesia in major orthopedic surgery.
Study context
- Population
- Elective THA/TKA patients, all-payor Premier Healthcare Database, 2006 to 2021THAs 587,919 and 499,484
- Exposure
- Neuraxial vs general anaesthesia for elective THA/TKA
- Outcome
- Adverse outcomes:
- PE
- Cerebrovascular events
- Pulmonary compromise
- Cardiac complications
- Acute MI
- Pneumonia
- All infections
- Acute renal failure
- Gastrointestinal complications
- Postoperative mechanical ventilation
- ICU admissions
- Blood transfusions
Methodological detailsmultivariable regression, Premier Healthcare Database
- Multivariable regression
- Premier Healthcare Database
Main finding
As reported in the abstract
Adverse outcomes among THAs, neuraxial vs general
Neuraxial vs GeneralOdds ratio (CI)P value
Acute renal failure, 2006-2015
0.72(0.65–0.80)
P < 0.001Acute renal failure, 2016-2021
0.56(0.50–0.63)
P < 0.001Blood transfusion, 2006-2015
0.91(0.89–0.94)
P < 0.001Blood transfusion, 2016-2021
0.44(0.41–0.47)
P < 0.001Observational data: associations, not effects.
Further findings
Neuraxial anaesthesia use among THAs
- Use in 2006
- 10.7%
- Use in 2021
- 25.7%
Adverse outcomes among TKAs (subgroup)
- Similar patterns existed for TKAs
Original publication
Comparative effectiveness of neuraxial versus general anesthesia in total joint replacement surgery: an updated retrospective analysis using more recent data. Reg Anesth Pain Med. Published 8 July 2024. doi:10.
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