Practice Variations in Anesthetic Care and Its Effect on Clinical Outcomes for Primary Total Hip Arthroplasties

J Arthroplasty. 2016 Apr;31(4):918-22. doi: 10.1016/j.arth.2015.08.031. Epub 2015 Aug 29.


Background: Knowledge regarding anesthetic practice variations in the use of general anesthesia (GA) vs neuraxial anesthesia (NA) as primary anesthetics for a primary total hip arthroplasty is limited.

Methods: A total of 107,490 cases were identified in the National Anesthesia Clinical Outcomes Registry, in which 31.7% and 68.3% were performed with NA and GA, respectively.

Results: Resident presence, board-certification status, comorbidities, and case duration were associated with the implementation of NA vs GA. Neuraxial anesthesia was associated with decreased rates of extended recovery room stay, inadequate pain control, and postoperative nausea/vomiting.

Conclusion: Anesthetic technique differences were associated with patient and provider characteristics. Our results can help improve quality measures and identify areas that need improvement in cost reduction and efficiency within this specific surgical patient population.

Keywords: anesthesia variation; hip arthroplasty; neuraxial anesthesia; outcomes; regional anesthesia.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, Conduction / statistics & numerical data*
  • Anesthesia, General / statistics & numerical data*
  • Arthroplasty, Replacement, Hip / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Nausea and Vomiting
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Registries
  • Treatment Outcome
  • United States / epidemiology
  • Young Adult