Outcome After Total Knee Arthroplasty Under General or Spinal Anesthesia
Status:
Completed
Trial end date:
2019-12-03
Target enrollment:
Participant gender:
Summary
Previous retrospective database studies suggest that total knee arthroplasty (TKA) surgery
under spinal anesthesia has less complications than when performed under general anesthesia.
In general, complications are rare and both anesthesia types are widely accepted. In Finland,
total knee arthroplasty has typically been performed under spinal anesthesia.
In a recent prospective randomized controlled study, total knee arthroplasty under general
anesthesia resulted in less acute postoperative pain (opioid-need measured by
patient-controlled anesthesia), less nausea, and faster hospital discharge than that
performed under spinal anesthesia. Also the use of surgical tourniquet can affect surgical
outcome: it may reduce bleeding and surgery time, but it may also cause weakness of thigh
muscles and thus hinder mobilization. In a recent study, both techniques with and without
surgical tourniquet appeared equal.
The aims of this study are to compare total knee arthroplasty under spinal or general
anesthesia, with or without surgical tourniquet, in relation to acute and chronic
postoperative pain, nausea, knee function, patient reported quality of life and satisfaction
on care, complications, length of stay, and need of surgical unit resources. This randomized
controlled study includes 400 patients with informed consent, 18-75-years-of-age, standard
primary total knee arthroplasty operation, American Society of Anesthesiologist (ASA)
physical status classification I-III, body mass index under 40, and no contraindications for
medications or treatments used.
The hypothesis of this study are used to reassess best practices of primary total knee
arthroplasty operation to enhance quality of care, patient outcomes and satisfaction, and
availability of surgery due to better patient flow at surgical unit.
Phase:
N/A
Details
Lead Sponsor:
Riku Antero Palanne
Collaborators:
Finland Helsinki University Central Hospital University of Helsinki