Comparison of Efficacy of Spinal Anaesthesia and General Anaesthesia for Total Knee Arthroplasty (TKA).

Abstract

Background: The purpose of this study was to compare the use of spinal anaesthesia with general anaesthesia for Total Knee Arthroplasty (TKA).

Material and methods: For this study, a total of 100 participants who had undergone total knee arthroplasty (TKA) were included. The process was explained to the subjects and they were requested to provide consent. The subjects who declined to participate in the study and refused to grant consent were excluded from the study. In addition, those who needed blood transfusion were not included in the study. Out of a total of 100 participants, 40 individuals received bilateral staggered procedures for the first time, while the remaining 60 individuals underwent unilateral total knee arthroplasties (TKAs). Patients undergoing total knee arthroplasty (TKA) under general anesthesia were administered intravenous propofol at a dosage of 2-3 mg/kg for induction. This was done either with or without the addition of rocuronium at a dosage of 0.6-1.0 mg/kg. Sevoflurane and desflurane, which are inhalational anesthetics, were employed to ventilate the patients' lungs while ensuring an oxygen saturation level of 80%. Subsequently, the air passage and breathing were upheld by introducing an appropriately sized i-gel. The minimum alveolar concentration of the inhalational drug was reduced to a range of 1-2.5, while the oxygen concentration was dropped to a range of 40-50%.

Results: There existed 55 patients in the general anaesthesia group while there existed 45 patients in the spinal anaesthesia group. The duration of hospitalization was 4 days for patients in the general anesthesia group and 2 days for patients in the spinal anesthesia group. Acute renal injury occurred in 6 individuals from the general anesthesia group and 3 individuals from the spinal anesthesia group. Out of the 9 participants in the general anesthesia group and the 4 subjects in the spinal anesthesia group, there were cases of cardiovascular problems. Pulmonary problems were observed in 6 individuals from the general anesthesia (GA) group and 8 individuals from the spinal anesthesia (SA) group. Neurologic problems were observed in 5 participants from the general anesthesia (GA) group and 1 participant from the spinal anesthesia (SA) group. Two participants in the GA group experienced surgical site infections, while no subjects in the SA group did. A total of 32 complications were observed in the general anesthesia (GA) group, while 18 complications were observed in the spinal anesthesia (SA) group. Therefore, the spinal anesthesia group experienced less issues compared to the general anesthesia group.

Conclusion: According to the findings of this study, the spinal anesthesia group had less problems compared to the general anesthesia group. There was no substantial difference in the effectiveness of these types of anesthesia.