Total Knee Replacement and Postoperative in Hospital Stay: General Versus Integrated Anaesthesia

B. Borghi, G. Gargioni, G. Massarelli, E. Pignotti

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Introduction. The aim of the study was to compare the influence on postoperative in hospital stay, in total knee arthroplasty, of intergrated anaesthesia (i.e. peridural analgesia linked to light general anaesthesia) venus general anaesthesia (GA). Methods. From 1-1-1992 to 30-6-1994) at the 1st Department of Anaesthesia and Intensive Care Unit 120 consecutive patients (mean age 67.8+6.6 years, range 38-86,25 M,95 F) were treated for knee prosthetic surgery. Patients were randomly divided into two groups, 48 were operated under GA and 72 under IA. The two groups did not differ for sex, age, body mass index, ASA groups; in the 1A group there was a higher although not significant incidence of coexiting diseases In all cases a blood saving program consisting of: predeposits, hemodilution, intraoperative blood salvage, Grst 8 hours postoperative hourly bleeding monitoring and blood salvaging with BT 797 Recovery Dideco (Mirondola Modena Italy) was applied. Intraoperative blood recovery was carried out when, during surgery, hemoglobin dropped more than 1 5g/dl(l). Results and DUcusiion. When relating type of anaesthesia with the analysis of first 8 hours hourly bleeding there was a significant greater total postoperative blood loss (i.e. POBL during 24 hours) and first 5 hours hourly bleeding in the IA group. In GA intraoperative blood salvage (IOBS) was greater while postoperative blood salvage (FOBS) was lower than in 1A group The incidence of allogenic transfusions was similar in both groups (table 1 ). The absence of major complications was higher although not significantly in patients treated with IA (table 2). The postoperative in hospital stay was significantly shorter for LA group than for GA group (table 3). This is probably due to peridural perioperative analgesia which facilitates mobilization and allows more effective and earlier physiotherapy Table 1: Blood salvage, poitoperative blood loss and allogenic trimfmions pts IA GA ANOVA IOBS pts 86(71%) 52(712%r 34(70.8%) NS IOBS(ml) 193±10 171±09 224±109 p=02 FOBS (ml) 575±252 621±218 494±288 P=.01 IOBS+POBS (ml) 806±250 816±205 789±319 NS POBL (ml/24 hours) 923±322 974±297 834±350 p=.03 Allotransfaaedpts 5 (4.1J.) 3(4.1%) 2(4.2%) NS Tabk2: PoatoptriHive eoroplict>on Compjications pts_IA_GA No major compiouons 108 68(94.4%) 40(83.3%) Haematoma 4 1(1.4%) 3(6.3%) Deep Vein Thrombosis (DVT) 4 2(2.8%) 2(4.1%) DVT+Pulmonary Embolism 1 0 1(2.1%) Respiratory failure 2 1(1.4%) 1(2.1%) Tachycardia 1 0 1(2.1%) Contingency table p = .6 NS Tbk 3: Potoptrtive in hoip Uy Cootimgaicy table; p_- OM IA GA Postoperative in hospital stay (days) 15.715.9 18 ±6.2.

Original languageEnglish
Pages (from-to)387
Number of pages1
JournalRegional Anesthesia
Issue number4
Publication statusPublished - 1996

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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