The study is a retrospective cohort study of adult patients undergoing outpatient primary unilateral total knee or total hip replacement surgeries from 2017 to 2019 assessing for difference in anesthetic techniques and outcomes.
The study is a retrospective cohort study of adult patients undergoing outpatient primary unilateral total knee or total hip replacement surgeries from 2017 to 2019. The purpose of the study is to evaluate the effects of anesthetic techniques for primary total joint replacement in Northern California Kaiser Permanente. The primary objective is to determine if there are clinically and statistically significant differences between the outcomes of general anesthesia and neuraxial anesthesia.
Study Type
OBSERVATIONAL
Enrollment
12,466
The anesthetic type either general anesthesia or neuraxial anesthesia is the intervention type for patients undergoing primary total joint arthroplasty of the knee or hip.
Kaiser Permanente Northern California
South San Francisco, California, United States
Postoperative Morbidity
30-day Postoperative Morbidity including surgical site infection (defined as infection involving the skin or subcutaneous tissue of the incision, deep incisional infection defined as infected tissue below the subcutaneous tissue including fascia and muscle), major coronary events (defined as nonfatal myocardial infarction, heart failure, ventricular tachycardia, cardiac arrest), pneumonia, urinary tract infection, venous thromboembolism, pulmonary embolism, cerebrovascular accident, renal injury/failure (Defined as increase in baseline creatinine 2 fold/3fold respectively).
Time frame: 30-day postoperative
Postoperative Mortality
30-day postoperative mortality - all cause
Time frame: 30-day postoperative
Postoperative readmission
30-day postoperative readmission - all cause
Time frame: 30-day postoperative
Intraoperative blood loss and transfusion rates
Measurement of blood loss by mL recorded on record. Measurement of packed red blood cells transfused by unit pack.
Time frame: Day of surgery
Intraoperative opioid use
Defined by type of analgesic medication and total morphine equivalence
Time frame: Day of surgery
Postoperative opioid use
Defined by type of analgesic medication and total morphine equivalence
Time frame: Day of surgery
Postoperative Pain Scores
Numerical Rating Scale of postsurgical pain measured until discharge from hospital. Numerical rating scale for pain is described as a scale from a minimum of 0, associated with no pain, to a maximum of 10, associated with the worst possible pain. A higher number is associated with a worse outcome.
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Time frame: Day of surgery
Postoperative nausea and vomiting
Rate of PONV after surgery
Time frame: Day of surgery
Length of postsurgical hospital stay
Length of time defined from end of intraoperative time to discharge from hospital time
Time frame: Day of surgery