Spinal anesthesia superior to general anesthesia for hip replacement

CHINA: Total-hip arthroplasty (THA) or hip replacement is a painful procedure, performed frequently. Patients undergoing THA may be offered either spinal anesthesia or general anesthesia. Now, a recent study published in the journal Medicine found that spinal anesthesia is superior to general anesthesia in terms of the occurrence of nausea and shorten the length of hospital stay.

In patients undergoing total hip arthroplasty, choosing an optimal anesthetic technique remains debated. Pu Xiang, Anesthesiology Department, Jingjiang People's Hospital, Jingjiang, Jiangsu Province, China, and colleagues conducted this meta-analysis to test the efficacy of general and spinal anesthesia in patients undergoing THA.

The researchers looked for data from randomized controlled trials (RCTs) that compared the use of general and spinal anesthesia for patients undergoing THA were retrieved. Five RCTs with 487 THAs were finally included for meta-analysis.

The primary outcome was to compare total blood loss. The secondary outcomes were the occurrence of deep venous thrombosis (DVT), the occurrence of nausea, and the length of hospital stay.

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They found that:

• There was no significant difference between the general anesthesia and spinal anesthesia in terms of the total blood loss and the occurrence of DVT.


• Compared with general anesthesia, spinal anesthesia was a significant reduction in the occurrence of nausea and the length of hospital stay.

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"In conclusion, we found that spinal anesthesia was superior to general anesthesia in terms of the occurrence of nausea and shorten the length of hospital stay. There was no significant difference between perioperative blood loss and the occurrence of DVT. Future research should be aimed at the optimal drug and dose for spinal anesthesia. In addition, more well-designed RCTs should be performed to confirm these results," wrote the authors.

For detailed study follow the link: doi: 10.1097/MD.0000000000014925