Neuraxial Anesthesia Beneficial for Bilateral Knee Arthroplasty

Lower rate of blood transfusions compared with general anesthesia

THURSDAY, Nov. 1 (HealthDay News) -- For patients undergoing bilateral total knee arthroplasty (BTKA), use of neuraxial anesthesia correlates with significantly lower rates of blood transfusions, according to research published in the November/December issue of Regional Anesthesia and Pain Medicine.

Ottokar Stundner, M.D., from the Hospital for Special Surgery in New York City, and colleagues examined the influence of type of anesthesia on perioperative outcomes after BTKA using data from a national database including 15,687 procedures. Of these, 80.1 percent were performed under general anesthesia, 6.8 percent under neuraxial anesthesia, and 13.1 percent under combined general and neuraxial anesthesia.

On average, patients undergoing neuraxial anesthesia were younger, with no difference in the overall comorbidity burden between the groups. The researchers found that blood transfusions were required significantly less frequently with neuraxial anesthesia, compared with the other groups. There were lower rates of in-hospital mortality, 30-day mortality, and complications in the neuraxial group, but these differences did not reach statistical significance. Compared with general anesthesia, neuraxial anesthesia alone and in combination with general anesthesia correlated respectively with a 16.0 and 6.0 percent reduction in major complications after adjustment, but the only significant association was reduced odds for the requirement of blood transfusions (neuraxial versus general, odds ratio, 0.52; neuraxial combined with general versus general, odds ratio, 0.77).

"Our data support the promotion of the use of neuraxial anesthesia for the management of BTKA patients, but also point out the demand for further research to quantify the magnitude of its beneficial effects," the authors write.

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