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    ICJR ABSTRACTS: Spinal Anesthesia Is Safer Than General Anesthesia in Revision Total Hip Arthroplasty

    At the 7th Annual ICJR South Hip & Knee Course, 6 awards were given to orthopaedic residents and fellows who submitted the best research abstracts in hip and knee replacements. The abstract Spinal Anesthesia is Safer Than General Anesthesia in Revision Total Hip Arthroplasty received the Best Question Award: Hip Arthroplasty and was presented at the meeting by Jacob M. Wilson, MD.

    RELATED: Register for the 8th Annual ICJR South Hip & Knee Course

    Authors

    Jacob M. Wilson, MD; Kevin X. Farley, BS; Thomas Bradbury, MD; and George N Guild, MD

    Introduction

    The incidence of revision total hip arthroplasty (rTHA) continues to increase. There is a need for the identification of risk factors in patients undergoing this procedure. There is a scarcity of literature examining the effect of anesthesia type in rTHA and we hypothesized that anesthesia choice would influence outcomes.

    Methods

    This is a retrospective cohort study utilizing the ACS-NSQIP database. Patients undergoing rTHA with either spinal or general anesthesia were identified. Coarsened exact matching (CEM) was used to match patient groups. Multivariate analysis was then performed on matched cohorts to asses for difference in outcomes after rTHA with general or spinal anesthesia.

    Results

    12,360 patients were included in this study. General anesthesia was found to be associated with significantly increased rates of: any major or minor complication (OR 1.51, 95%CI 1.24-1.84), deep vein thrombosis (OR 3.96, 95%CI 1.58-9.0), mortality (OR 3.72, 95%CI 1.31-10.50), unplanned intubation or failure to wean from intubation, transfusion, non-home discharge, readmission, reoperation, operating room time, and hospital length of stay.

    Conclusion

    In patients undergoing rTHA, general anesthesia is associated with increased risk of multiple complications. The current investigation would suggest that spinal anesthesia should be used for rTHA patients when not otherwise clinically contraindicated.

    Click the image above to watch Dr. Wilson’s presentation of this Best Question Award-winning abstract.

    Author Information

    Jacob M. Wilson, MD; Kevin X. Farley, BS; Thomas Bradbury, MD; and George N Guild, MD, are from the Department of Orthopaedic Surgery at Emory University School of Medicine, Atlanta, Georgia.