Incidents occuring during anesthesia for total hip arthroplasty: a comparison of general versus regional anaesthesia

TitreIncidents occuring during anesthesia for total hip arthroplasty: a comparison of general versus regional anaesthesia
Publication TypeConference Paper
Year of Publication2009
AuthorsAdam, A, Taffé, P, Pittet, V, Pichard, S, Muller, J, Burnand, B, Study, GADS
Conference NameAnnual meeting of the Swiss Society of Anaesthesiology and Resuscitation, Interlaken (Switzerland), October 29-31, 2009
ISBN Number1424-7860
Accession Numberserval:BIB_8A1C289894D2
Mots-clésAnesthesia, Anesthesia/adverse effects, Arthroplasty, General, Hip, Local, Replacement
Abstract

Background: The type of anesthesia to be used for total hip arthroplasty (THA) is still a matter of debate. We compared the occurrence of per- and post-anesthesia incidents in patients receiving either general (GA) or regional anesthesia (RA).
Methods: We used data from 29 hospitals, routinely collected in the Anaesthesia Databank Switzerland register between January 2001 and December 2003. We used multi-level logistic regression models.
Results: There were more per- and post-anesthesia incidents under GA compared to RA (35.1% vs 32.7 %, n = 3191, and 23.1% vs 19.4%, n = 3258, respectively). In multi-level logistic regression analysis, RA was significantly associated with a lower incidence of per-anesthetic problems, especially hypertension, compared with GA. During the post-anesthetic period, RA was also less associated with pain. Conversely, RA was more associated with post-anesthetic hypotension, especially for epidural technique. In addition, age and ASA were more associated with incidents under GA compared to RA. Men were more associated with per-anesthetic problems under RA compared to GA. Whereas increased age (>67), gender (male), and ASA were linked with the choice of RA, we noticed that this choice depended also on hospital practices after we adjusted for the other variables.
Conclusions: Compared to RA, GA was associated with an increased proportion of per- and post-anesthesia incidents. Although this study is only observational, it is rooted in daily practice. Whereas RA might be routinely proposed, GA might be indicated because of contraindications to RA, patients' preferences or other surgical or anaesthesiology related reasons. Finally, the choice of a type of anesthesia seems to depend on local practices that may differ between hospitals.

Notes

oai:serval.unil.ch:BIB_8A1C289894D2

URLhttp://www.smw.ch/docs/PdfContent/smw-12957.pdf
Citation Key / SERVAL ID4669

                         

IUMSP | www.iumsp.ch
Institut universitaire de médecine sociale et préventive
Route de la Corniche 10, 1010 Lausanne - Switzerland
+41 21 314 72 72 | iumsp@chuv.ch

Go to top