Incidents occuring during anesthesia for total hip arthroplasty: a comparison of general versus regional anaesthesia

Détails

ID Serval
serval:BIB_8A1C289894D2
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Titre
Incidents occuring during anesthesia for total hip arthroplasty: a comparison of general versus regional anaesthesia
Titre de la conférence
Annual meeting of the Swiss Society of Anaesthesiology and Resuscitation, Interlaken (Switzerland), October 29-31, 2009
Auteur(s)
Adam Angéline, Taffé Patrick, Pittet Valérie, Pichard Silvia, Muller Jacques, Burnand Bernard
Collaborateur(s)
ADS Study Group
ISBN
1424-7860
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
139
Série
Swiss Medical Weekly
Pages
3S
Langue
anglais
Résumé
Background: The type of anesthesia to be used for total hip arthroplasty (THA) is still a matter of debate. We compared the occurrence of per- and post-anesthesia incidents in patients receiving either general (GA) or regional anesthesia (RA).
Methods: We used data from 29 hospitals, routinely collected in the Anaesthesia Databank Switzerland register between January 2001 and December 2003. We used multi-level logistic regression models.
Results: There were more per- and post-anesthesia incidents under GA compared to RA (35.1% vs 32.7 %, n = 3191, and 23.1% vs 19.4%, n = 3258, respectively). In multi-level logistic regression analysis, RA was significantly associated with a lower incidence of per-anesthetic problems, especially hypertension, compared with GA. During the post-anesthetic period, RA was also less associated with pain. Conversely, RA was more associated with post-anesthetic hypotension, especially for epidural technique. In addition, age and ASA were more associated with incidents under GA compared to RA. Men were more associated with per-anesthetic problems under RA compared to GA. Whereas increased age (>67), gender (male), and ASA were linked with the choice of RA, we noticed that this choice depended also on hospital practices after we adjusted for the other variables.
Conclusions: Compared to RA, GA was associated with an increased proportion of per- and post-anesthesia incidents. Although this study is only observational, it is rooted in daily practice. Whereas RA might be routinely proposed, GA might be indicated because of contraindications to RA, patients' preferences or other surgical or anaesthesiology related reasons. Finally, the choice of a type of anesthesia seems to depend on local practices that may differ between hospitals.
Mots-clé
Arthroplasty, Replacement, Hip , Anesthesia/adverse effects , Anesthesia, General , Anesthesia, Local
Création de la notice
04/01/2010 10:43
Dernière modification de la notice
03/03/2018 19:09
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