• Jaime L Baratta and Eric S Schwenk.
• Associate Professor of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University.
• Curr Opin Anaesthesiol. 2022 Oct 1; 35 (5): 621625621-625.

Purpose Of ReviewWith the removal of both total knee and total hip arthroplasty from the Centers for Medicare and Medicaid Services' inpatient-only list, efforts to improve efficiency of the perioperative management of total joint patients have increased recently. The publication of several recent studies examining the impact of anesthesia type on outcomes has prompted the need to review the overall state of evidence for spinal versus general anesthesia for outpatient total joint arthroplasty.Recent FindingsOverall complication rates are low in this carefully selected patient population. The majority of patients who are preselected for outpatient total joint arthroplasty appear to successfully achieve this outcome. Some retrospective studies have suggested a benefit for spinal anesthesia in terms of same-day discharge success but direct comparisons in prospective studies are lacking.SummaryThe type of anesthesia used for total joint arthroplasty may have an important effect on outcomes. Until randomized control trials are performed we must rely on existing evidence, which suggests that both spinal and general anesthesia can lead to successful outcomes after ambulatory total joint arthroplasty.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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