Evaluation of Anesthetic Techniques in Outpatient Total Joint Replacement Surgery in an Integrated Health Care Delivery System
- Conditions
- Osteoarthritis, HipOsteoarthritis, KneeAnesthesia Morbidity
- Interventions
- Procedure: Anesthesia Type
- Registration Number
- NCT04203732
- Lead Sponsor
- Kaiser Permanente
- 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.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 12466
- ASA 1 - IV patients
- Age > 18
- Primary total hip/knee replacement
- 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
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Total Joint Arthroplasty Anesthesia Type The cohort includes patients undergoing outpatient primary total joint replacement surgeries from 2017 to 2019. Primary total joint surgery is defined as patients who undergo unilateral total knee replacement or total hip replacement for the first time during the study years
- Primary Outcome Measures
Name Time Method 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 Outcome Measures
Name Time Method Postoperative readmission 30-day postoperative 30-day postoperative readmission - all cause
Postoperative opioid use Day of surgery Defined by type of analgesic medication and total morphine equivalence
Postoperative Mortality 30-day postoperative 30-day postoperative mortality - 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.
Length of postsurgical hospital stay Day of surgery Length of time defined from end of intraoperative time to discharge from hospital time
Intraoperative 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
Trial Locations
- Locations (1)
Kaiser Permanente Northern California
🇺🇸South San Francisco, California, United States