Effect of neuraxial anesthesia for total joints on outcomes

Editor's Note

Increased use of neuraxial anesthesia for total hip and knee patients was linked to lower hospitalization costs in this study.

National data on 808,237 total knee and 371,607 total hip replacements were used in the analysis. Multivariable associations were measured between hospital neuraxial anesthesia volume (quartiles) and outcomes (respiratory/cardiac complications, blood transfusion/ICU need, opioid utilization, and length/cost of hospitalization).

Annual neuraxial anesthesia volume varied greatly−interquartile range, 3 to 78 for hips and 6 to 163 for knees. Though increasing frequency of neuraxial anesthesia was not linked to improvements in any of the clinical outcomes, significant reductions in hospitalization costs of up to -14.1% for total knees and -15.6% for total hips were found.

Additional studies are needed before considering neuraxial anesthesia use as a marker of quality, the authors say.