Does Total Intravenous Anesthesia with Short-acting Spinal Anesthetics in PrimaryHipandKneeArthroplasty Facilitate Early Hospital Discharge?

Derek M. Klavas, Azim Karim, Bradley S. Lambert, Marley Sam Ferris, Domenica Delgado, Stephen J. Incavo

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Introduction: Our study assessed the effect of total intravenous anesthesia (TIVA) with short-acting spinal anesthesia and aggressive day-of-surgery postoperative day 0 physical therapy (POD#0 PT) on hospital length of stay (LOS) in patients who underwent primary total joint arthroplasty. Methods: A retrospective chart review compared the hospital LOS of 116 patients who underwent primary total hip arthroplasty and total knee arthroplasty with TIVA and short-acting spinal blockade ("Updated protocol group") with that of the control group of 228 patients who were under standard anesthesia ("Traditional protocol group"). Results: Both total hip arthroplasty and total knee arthroplasty patients in the Updated protocol group had markedly reduced LOS compared with those in the Traditional protocol group (1.56 0.1 days versus 2.4±0.1 days; P<0.05 and 1.4±0.1 days versus 2.3±0.1 days P<0.05). A higher proportion of patients in the Updated protocol group received at least 1 POD#0 PT session compared with those in the Traditional protocol group. Conclusion: Total intravenous anesthesia combined with shortacting spinal anesthetics provided the following benefits for patients who underwent primary total joint arthroplasty: More day-of-surgery PT sessions and earlier discharge by nearly 1 full day.

Original languageEnglish (US)
Pages (from-to)e221-e229
JournalThe Journal of the American Academy of Orthopaedic Surgeons
Volume26
Issue number10
Early online dateApr 23 2018
DOIs
StatePublished - May 15 2018

Keywords

  • Journal Article

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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