Comparative Analysis Of Postoperative Outcomes Between Neuraxial Versus General Anesthesia For Total Hip Arthroplasty

Faculty Advisor(s)

John Hanlon

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© 2017 Ali M. Gilmore


The practice of modern anesthesia provides myriad anesthetic options for patients undergoing Total Hip Arthroplasty (THA). Currently the most commonly utilized anesthetic techniques discussed herin are (1) general anesthesia using volatile anesthetics and (2) neuraxial anesthesia, using local anesthetics. Both anesthetic techniques have benefits and drawbacks that contribute not only to postoperative patient outcomes but also economic bottom line for healthcare facilities. In seeking to elucidate whether or not one technique versus the other provides an overall advantage on postoperative patient outcomes the research indicates there is negligible difference between negative postoperative outcomes whichever technique is employed. To date, there are few large-scale randomized control trials (RCTs) that have taken up this matter; as a result it has been difficult to come up with a definitive answer to the question.

The research methods for this paper consisted of database searches using Medline/PubMed Resources Guide, EBSCO/CINAHL, and the Cochrane Central Database of Controlled Trials from inception until November 2016 were utilized. Search terms included randomized controlled trials, retrospective, prospective comparative studies researching morbidity, mortality and postoperative outcomes comparing neuraxial (spinal or epidural) with general anesthesia for total hip arthroplasty were included. While there is an abundance of granular data available with regard to the two anesthetic techniques and postoperative outcomes, these database studies lack overall context, which prevent answering the question in a black and white fashion. Solutions that gets closer to answering the question, of which anesthetic technique provides better postoperative outcomes, is to detail specific patient populations in which these anesthetics techniques are to be employed. Once definitive parameters are defined, the next step is to incorporate these specifics into, and expand the number of RCTs researching the postoperative outcomes between the two anesthetic techniques in specific patient populations.


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