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The aim of this study is to investigate the effect of combined spinoepidural and general anesthesia on the incidence of postoperative complications following total knee arthroplasty
Total knee arthroplasty is known to cause complications (pulmonary thromboembolism, acute kidney injury, arryhthmias and infection). The investigators aimed to study the effects of two different anesthesia techniques, i.e. combined spinoepidural anesthesia and general anesthesia on the incidence of postoperative complications such as arrhythmia, pulmonary thrombeoembolism, infection, acute kidney injury and mortality.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| General Anesthesia | Active Comparator | The patients in this group will undergo unilateral total knee arthroplasty under general anesthesia. Following vascular access and monitorization (non-invasive blood pressure, saturation, electrocardiography). Epidural chateterisation will be performed and test dose will be applied. Induction will be carried out using propofol (3mg/kg), fentanyl (1cmg/kg) and rocuronium (0.6 mg/kg). Maintenance will be carried out using sevoflurane (%2-3) and 50-50% mixture of nitrous oxide and oxygen. Epidural analgesia will be initiated after the end surgery. |
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| Regional Anesthesia | Active Comparator | The patients in this group will undergo unilateral total knee arthroplasty under combined spinoedpidural anesthesia . Following vascular access and monitorization (noninvasive blood pressure, oxygen saturation and electrocardiography), spinal anesthesia will be performed using 12,5 mg marcaine given to the subarachnoid space and epidural analgesia will be initiated at the end of surgery following negative test dose. The patients will be given nasal oxygen supplementation. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| General Anesthesia | Other | The patients in general anesthesia group will undergo general anesthesia |
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| Measure | Description | Time Frame |
|---|---|---|
| Acute Kidney Injury | Number of participants with new onset acute kidney injury | Postoperative first day |
| Acute Kidney Injury | Number of participants with new onset acute kidney injury | Postoperative sixth week |
| Pulmonary Thromboembolism | Number of participants with new onset pulmonary thromboembolism | Postoperative first day |
| Pulmonary Thromboembolism | Number of participants with new onset pulmonary thromboembolism | Postoperative sixth week |
| Infection | Number of participants with new onset infection | Postoperative first day |
| Infection | Number of participants with new onset infection | Postoperative sixth week |
| Arryhthmia | Number of participants with new onset arryhthmia requiring treatment | Postoperative first day |
| Arryhthmia | Number of participants with new onset arryhthmia requiring treatment | Postoperative sixth week |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Perihan Ekmekçi, MD | Contact | +903122044000 | 4099 | erdogduperi@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ufuk University Dr. Rıdvan Ege Hospital | Recruiting | Ankara | 06520 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23612126 | Background | Memtsoudis SG, Sun X, Chiu YL, Stundner O, Liu SS, Banerjee S, Mazumdar M, Sharrock NE. Perioperative comparative effectiveness of anesthetic technique in orthopedic patients. Anesthesiology. 2013 May;118(5):1046-58. doi: 10.1097/ALN.0b013e318286061d. | |
| 23080348 | Background | Stundner O, Chiu YL, Sun X, Mazumdar M, Fleischut P, Poultsides L, Gerner P, Fritsch G, Memtsoudis SG. Comparative perioperative outcomes associated with neuraxial versus general anesthesia for simultaneous bilateral total knee arthroplasty. Reg Anesth Pain Med. 2012 Nov-Dec;37(6):638-44. doi: 10.1097/AAP.0b013e31826e1494. |
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| ID | Term |
|---|---|
| D000768 | Anesthesia, General |
| D000765 | Anesthesia, Conduction |
| ID | Term |
|---|---|
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
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| Regional Anesthesia | Other | The patients in Group R will be given combined spinoepidural anesthesia |
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| Death | Number of participants with mortality | Postoperative first day |
| Death | Number of participants with mortality | Postoperative sixth week |