Key result
Caudal epidural and spinal-epidural anesthesia were more effective than general anesthesia in reducing perioperative adverse effects, pain, and cognitive dysfunction in total hip arthroplasty.
Why the study?
Do caudal epidural anesthesia or spinal-epidural anesthesia improve postoperative pain, cognitive dysfunction, and safety compared to general anesthesia in patients undergoing total hip arthroplasty?
RCT (n=198)
Do caudal epidural anesthesia or spinal-epidural anesthesia improve postoperative pain, cognitive dysfunction, and safety compared to general anesthesia in patients undergoing total hip arthroplasty?
Caudal epidural and spinal-epidural anesthesia are associated with fewer adverse effects, better pain control, and less cognitive dysfunction than general anesthesia in total hip arthroplasty.
May inform anesthesia selection in hip arthroplasty; leaves open confirmation via randomized trials.
BACKGROUND This study compared the efficacy and safety of 3 different anesthesia techniques used in total hip arthroplasty (THA). MATERIAL AND METHODS We allocated 198 patients preparing to undertake THA into 3 groups: general anesthesia group (GA group, n=66), caudal epidural anesthesia group (CEA group, n=66), and spinal-epidural anesthesia group (SEA group, n=66). We compared postoperative adverse effects occurring in patients of the 3 anesthesia groups. The Visual Analog Scale (VAS) score, Minimum Mental State Examination (MMSE) score, and β-amyloid (Aβ) expression were calculated to determine the effects of different anesthesia on the postoperative pain and cognitive dysfunction of patients. RESULTS The CEA and SEA groups had lower rates of perioperative adverse effects than in the GA group. Patients in the GA group required significantly higher administration of analgesics after the surgery than those in CEA and SEA groups. Higher Aβ expression levels and VAS scores, as well as lower MMSE scores, were also seen in the GA group compared with the other 2 groups. CONCLUSIONS CEA and SEA were more effective than GA in THA, and CEA seemed to be a better anesthesia technique than SEA.
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Liang et al. (2017) conducted an RCT in Total hip arthroplasty (n=198). Caudal epidural anesthesia and spinal-epidural anesthesia vs. General anesthesia was evaluated on Postoperative adverse effects, pain (VAS score), and cognitive dysfunction (MMSE score and β-amyloid expression). Caudal epidural and spinal-epidural anesthesia were more effective than general anesthesia in reducing perioperative adverse effects, pain, and cognitive dysfunction in total hip arthroplasty.
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