Spinal or General Anesthesia for Total Hip Arthroplasty

The optimal choice of anesthesia — spinal or general — often is debated for patients undergoing total hip arthroplasty (THA). Mayo Clinic researchers retrospectively evaluated approximately 14,000 primary THAs (mean patient age, 64; average body-mass index, 31 kg/m²) performed during a 15-year period. General anesthesia was administered in 58% of cases.

Patients who received spinal anesthesia had lower mean pain scores throughout their hospitalizations, along with 26% less opioid use. After adjustment for multiple variables, patients who received spinal anesthesia experienced significantly fewer episodes of altered mental status (odds ratio, 0.7) and required fewer blood transfusions (OR, 0.7) and intensive care admissions (OR, 0.7); however…