Comparing general and regional anesthesia in patients undergoing primary total hip arthroplasty: analysis of national health insurance data in Korea

TL;DR

This study compares general and regional anesthesia in hip replacement surgery, finding similar outcomes but higher costs with general anesthesia.

Contribution

The study provides new evidence on the comparative safety and cost of general versus regional anesthesia for total hip arthroplasty.

Findings

General anesthesia was associated with higher prosthesis failure and ICU admission rates.

Total costs were significantly higher with general anesthesia.

Mortality and complication rates were comparable between the two anesthesia types.

Abstract

To compare the effects of general and regional anesthesia on clinical outcomes following primary total hip arthroplasty (THA).

This retrospective study using data from the Korean National Health Insurance Research Database included 1,522 patients who underwent THA under general anesthesia (n = 640) or regional anesthesia (n = 882) between 2002 and 2015. We compared the mortality and complication rates within 30 days after surgery.

Prosthesis failure (1.56% vs. 0.45%, p = 0.025), admission to the intensive care unit (9.53 vs. 5.44%, p = 0.0023), and total cost (₩7,332,515 vs. ₩6,833,295, p < 0.0001) were higher in the general anesthesia group than in the regional anesthesia group. No significant differences were observed in mortality (0.94% vs. 0.57%, p = 0.54), transfusion rate (81.1% vs. 80.9%, p = 0.94), length of hospital stay (45 vs. 45 days, p = 0.23), or other complications between the groups. Similar results were observed in propensity-score matched analysis (n = 640 patients per group).

Our study showed that both anesthesia types resulted in comparable mortality and complication rates in patients who underwent THA, but the costs differed.

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