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Operative room time comparison between general and spinal anesthesia in total hip arthroplasty: an institutional study

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

A relatively high expense with any procedure is total operative time; two components being the time spent anesthetizing the patient and time spent transferring the patient out of the operating room (OR). Both times can be affected by the anesthetic method used. This study compares different operative time intervals for both spinal anesthesia (SA) and general anesthesia (GA), in patients undergoing a primary total hip arthroplasty (THA), to identify the most appropriate and cost-effective anesthetic method.

Methods

A retrospective chart review was performed at a single institution for primary total hip arthroplasty procedures performed in the year 2019. Primary THAs without complications performed by three orthopedic surgeons were selected. Anesthesia records for 200 patients were used to compare perioperative time intervals; 100 consecutive patients that received SA and 100 consecutive patients that received GA.

Results

The time spent transferring the patient out of the operating room was 8 min for GA and 5 min for SA (p < 0.001). Total operative time for GA was 90 min and 87 min for SA (p = 0.3330). Total pre-operative time averaged 26 min in SA compared to 25 min in GA (p = 0.5874). Non-operative total time (all time components of patient interaction excluding surgery start to surgery finish) was significantly shorter in SA with an average of 52 compared to 56 in GA (p = 0.0151).

Conclusion

Time to transfer patient out of the OR and total non-operative time was significantly shorter in patients who received spinal anesthesia. These results and the complications of both general and spinal anesthesia should be taken into consideration when anesthetizing patients undergoing primary THA.

Level of evidence

III.

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Data availability

The data underlying this article will be shared on reasonable request to the corresponding author.

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Acknowledgements

Henry Paiste, BSb, (hpaiste@uab.edu), Medical Student. Gerald McGwin, PhDc, (gmcgwin@uabmc.edu), Professor.

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Authors and Affiliations

  1. Division of Orthopaedic Surgery, Department of Orthopaedic Surgery, University of Alabama at Birmingham, 1201 11th Ave S #200, Birmingham, AL, 35205, USA

    Mackenzie Sowers, Roshan Jacob, Kelly Chandler, Sakthivel Rajaram & Sameer Naranje

  2. Department of Anesthesiology, University of Alabama at Birmingham, JT 845 619 South 19th Street, Birmingham, AL, 35249, USA

    George E. Kuntz IV & Promil Kukreja

Authors
  1. Mackenzie Sowers
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  2. Roshan Jacob
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  3. Kelly Chandler
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  4. George E. Kuntz IV
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  5. Sakthivel Rajaram
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  6. Promil Kukreja
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  7. Sameer Naranje
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Contributions

MS: contributed to investigation, writing—original draft, visualization. RJ: contributed to writing—original draft, writing—review and editing, visualization. KC: contributed to investigation, writing—original draft, visualization. GEKIV: contributed to writing—conceptualization, review and editing. SR: contributed to conceptualization, review and editing, supervision. PK: contributed to conceptualization, review and editing, supervision. SN: contributed to conceptualization, review and editing, supervision.

Corresponding author

Correspondence to Sameer Naranje.

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The authors have no conflicts of interest to declare.

Ethical approval

This study was approved by the IRB board at the University of Alabama at Birmingham.

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Sowers, M., Jacob, R., Chandler, K. et al. Operative room time comparison between general and spinal anesthesia in total hip arthroplasty: an institutional study. Arch Orthop Trauma Surg 143, 4755–4761 (2023). https://doi.org/10.1007/s00402-023-04775-4

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  • DOI: https://doi.org/10.1007/s00402-023-04775-4

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