Anesthesia Morbidity, Osteoarthritis, Hip, Osteoarthritis, Knee
Conditions
Keywords
Retrospective Cohort, Anesthetic Technique, Total Joint Arthroplasty
Brief summary
The study is a retrospective cohort study of adult patients undergoing outpatient primary unilateral total knee or total hip replacement surgeries from 2017 to 2019 assessing for difference in anesthetic techniques and outcomes.
Detailed description
The study is a retrospective cohort study of adult patients undergoing outpatient primary unilateral total knee or total hip replacement surgeries from 2017 to 2019. The purpose of the study is to evaluate the effects of anesthetic techniques for primary total joint replacement in Northern California Kaiser Permanente. The primary objective is to determine if there are clinically and statistically significant differences between the outcomes of general anesthesia and neuraxial anesthesia.
Interventions
PROCEDUREAnesthesia Type
The anesthetic type either general anesthesia or neuraxial anesthesia is the intervention type for patients undergoing primary total joint arthroplasty of the knee or hip.
Sponsors
Kaiser Permanente
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* ASA 1 - IV patients * Age \> 18 * Primary total hip/knee replacement
Exclusion criteria
* Total joint replacement for oncologic tumors * Emergent surgery * Age \< 17 * Pregnant Female * Neuraxial anesthesia conversion to general anesthesia * Revision total joint replacement * Bilateral total joint replacement
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Morbidity | 30-day postoperative | 30-day Postoperative Morbidity including surgical site infection (defined as infection involving the skin or subcutaneous tissue of the incision, deep incisional infection defined as infected tissue below the subcutaneous tissue including fascia and muscle), major coronary events (defined as nonfatal myocardial infarction, heart failure, ventricular tachycardia, cardiac arrest), pneumonia, urinary tract infection, venous thromboembolism, pulmonary embolism, cerebrovascular accident, renal injury/failure (Defined as increase in baseline creatinine 2 fold/3fold respectively). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Mortality | 30-day postoperative | 30-day postoperative mortality - all cause |
| Postoperative readmission | 30-day postoperative | 30-day postoperative readmission - all cause |
| Intraoperative blood loss and transfusion rates | Day of surgery | Measurement of blood loss by mL recorded on record. Measurement of packed red blood cells transfused by unit pack. |
| Intraoperative opioid use | Day of surgery | Defined by type of analgesic medication and total morphine equivalence |
| Postoperative opioid use | Day of surgery | Defined by type of analgesic medication and total morphine equivalence |
| Postoperative Pain Scores | Day of surgery | Numerical Rating Scale of postsurgical pain measured until discharge from hospital. Numerical rating scale for pain is described as a scale from a minimum of 0, associated with no pain, to a maximum of 10, associated with the worst possible pain. A higher number is associated with a worse outcome. |
| Postoperative nausea and vomiting | Day of surgery | Rate of PONV after surgery |
| Length of postsurgical hospital stay | Day of surgery | Length of time defined from end of intraoperative time to discharge from hospital time |
Countries
United States
Outcome results
None listed