School of Medicine and Health Sciences Poster Presentations

Title

The Impact of Anesthesia Type on Postoperative Outcome and Complications in Patients Undergoing Revision Total Knee Arthroplasty

Poster Number

186

Document Type

Poster

Status

Medical Resident

Abstract Category

Clinical Specialties

Keywords

revision, knee, anesthesia, general, regional,

Publication Date

Spring 2018

Abstract

Background: Revision total knee arthroplasty is an increasingly common procedure and is effective in treating knee osteoarthritis, but has higher complication rates than primary total knee arthroplasty. Anesthetic choice offers a perioperative risk factor that has been extensively studied in primary total knee arthroplasty, showing favorable results for regional anesthesia compared to general anesthesia. Anesthetic choice in revision total knee arthroplasties can be optimized to reduce complications and improve health outcomes.

Methods: A retrospective study was conducted using the American College of Surgeons National Surgical Quality Improvement Program database. Patients who underwent revision total knee arthroplasties between 2007 and 2014 were divided into three anesthesia cohorts. Univariate and multivariate analyses were used to analyze perioperative factors.

Results: From 9899 patients, 6435 received general anesthesia, 3098 received regional anesthesia, and 366 received Monitored Anesthesia Care/IV Sedation. Patients receiving general anesthesia had increased risk for six adverse outcomes compared to patients receiving regional anesthesia, and one adverse outcome compared to patients receiving Monitored Anesthesia Care/IV sedation. General anesthesia independently increased risk for deep surgical site infection, urinary tract infection, and sepsis compared with regional anesthesia. General anesthesia was shown to be an independent risk factor for having an extended length of hospital stay compared with regional anesthesia or Monitored Anesthesia Care/IV sedation.

Conclusion: Patients receiving general anesthesia have increased likelihood for developing adverse postoperative outcomes relative to patients receiving regional anesthesia and Monitored Anesthesia Care/IV sedation. Though complication rates remained low, anesthesiologists must consider the implications of anesthetic choice on postoperative outcomes.

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Creative Commons License
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The Impact of Anesthesia Type on Postoperative Outcome and Complications in Patients Undergoing Revision Total Knee Arthroplasty

Background: Revision total knee arthroplasty is an increasingly common procedure and is effective in treating knee osteoarthritis, but has higher complication rates than primary total knee arthroplasty. Anesthetic choice offers a perioperative risk factor that has been extensively studied in primary total knee arthroplasty, showing favorable results for regional anesthesia compared to general anesthesia. Anesthetic choice in revision total knee arthroplasties can be optimized to reduce complications and improve health outcomes.

Methods: A retrospective study was conducted using the American College of Surgeons National Surgical Quality Improvement Program database. Patients who underwent revision total knee arthroplasties between 2007 and 2014 were divided into three anesthesia cohorts. Univariate and multivariate analyses were used to analyze perioperative factors.

Results: From 9899 patients, 6435 received general anesthesia, 3098 received regional anesthesia, and 366 received Monitored Anesthesia Care/IV Sedation. Patients receiving general anesthesia had increased risk for six adverse outcomes compared to patients receiving regional anesthesia, and one adverse outcome compared to patients receiving Monitored Anesthesia Care/IV sedation. General anesthesia independently increased risk for deep surgical site infection, urinary tract infection, and sepsis compared with regional anesthesia. General anesthesia was shown to be an independent risk factor for having an extended length of hospital stay compared with regional anesthesia or Monitored Anesthesia Care/IV sedation.

Conclusion: Patients receiving general anesthesia have increased likelihood for developing adverse postoperative outcomes relative to patients receiving regional anesthesia and Monitored Anesthesia Care/IV sedation. Though complication rates remained low, anesthesiologists must consider the implications of anesthetic choice on postoperative outcomes.