General Anesthesia May Up Surgical Site Infection Risk

After total hip or knee replacement, risk higher with general than epidural/spinal anesthesia
By Beth Gilbert
HealthDay Reporter

THURSDAY, July 29 (HealthDay News) -- Patients who undergo a primary total hip or knee replacement procedure with general anesthesia have a higher risk of surgical site infection (SSI) than those who undergo the procedure with epidural/spinal anesthesia, according to a study published in the August issue of Anesthesiology.

Chuen-Chau Chang, M.D., of the Taipei Medical University Hospital in Taiwan, and colleagues evaluated 3,081 patients from Taiwan's Longitudinal Health Insurance Database who underwent a primary total hip or knee replacement between 2002 and 2006. The researchers examined the risk of SSI within 30 days of surgery in those who were under general anesthesia compared to those under epidural/spinal anesthesia.

The researchers found that 56 patients (1.8 percent) developed SSIs within 30 days. Of those, 33 (2.8 percent of all under general anesthesia) had general anesthesia and 23 (1.2 percent of all under epidural/spinal anesthesia) had epidural/spinal anesthesia. After adjusting for the patient's age, sex, year of surgery, comorbid conditions, surgeon's age, and hospital teaching status, the odds of SSI for patients receiving total hip or knee replacement under general anesthesia were 2.21 times higher than for those undergoing the same procedure under epidural/spinal anesthesia.

"Our results support the evolving concept of long-term consequences of anesthesia and emphasize the anesthesiologist's role in preventing SSIs," the authors write.

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