Neuraxial anesthesia is associated with lower rates of perioperative transfusion in patients undergoing bilateral total hip replacement when compared to general anesthesia, although not significantly with other post-operative outcomes.

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• Brittany N Burton, Jennifer A Padwal, Matthew W Swisher, Courtni R Salinas, and Rodney A Gabriel.
• School of Medicine, University of California, San Diego, San Diego, CA, USA.
• J Clin Anesth. 2019 Feb 1; 52: 71-75.

Study ObjectiveCurrent evidence remains limited on the postoperative outcomes of neuraxial (NA) versus general anesthesia (GA) as primary anesthesia type in patients receiving simultaneous bilateral total hip arthroplasty (BTHA). We aimed to evaluate the rates of postoperative outcomes among patients receiving NA versus GA for BTHA.DesignRetrospective cohort study.SettingMulti-institutional.PatientsA total of 798 patients undergoing BTHA with 519 and 279 who received GA and NA, respectively. We used the American College of Surgeons - National Surgical Quality Improvement Program database for years 2007 to 2016.InterventionsPatients undergoing BTHA.MeasurementsWe propensity-score matched on demographic factors and comorbid conditions to compare rates of postoperative outcomes among cohorts (NA versus GA). We performed Pearson chi-square and Wilcoxon rank sum test to compare NA versus GA cohorts.Main ResultsThe final analysis included 798 BTHA patients, of which 35% received NA as the primary anesthetic. The median age was 58 years old and 50.8% were female. The rate of perioperative transfusion in the NA and GA group were 20.1% and 29.0%, respectively (p = 0.02). There were no significant differences in the rate of postoperative outcomes between patients receiving NA versus GA as their primary anesthesia type (Bonferroni corrected p < 0.006 was considered statistically significant).ConclusionOur study showed no significant differences in postoperative outcomes between NA versus GA following BTHA. Further studies are needed to investigate outcomes among this surgical population.Copyright © 2018 Elsevier Inc. All rights reserved.

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