Spinal Anaesthesia vs General Anaesthesia in Hip Replacement Surgery

Hip replacement surgery is one of the most common operations worldwide, helping people regain mobility and improve quality of life. One important decision during surgery is whether to have spinal anaesthesia or general anaesthesia.
A major study from the American Joint Replacement Registry (AJRR) gives us new insights into this choice, showing that spinal anaesthesia often leads to better outcomes.

What Did the Study Look At?
Researchers reviewed data from over 217,000 total hip replacements performed between 2017 and 2020. Patients were grouped by whether they had:

  • Spinal anaesthesia: Medication injected into the lower back, numbing the body from the waist down.
  • General anaesthesia: Medication that makes you fully unconscious during surgery.

Key Findings
The study found that patients who received spinal anaesthesia often did better than those who had general anaesthesia. Specifically, spinal anaesthesia was linked to:

  • Shorter operations – meaning less time in the operating room.
  • Faster recovery – patients were able to get back on their feet sooner.
  • Fewer long hospital stays – fewer patients stayed in hospital longer than 3 days.
  • Lower readmission rates – fewer people needed to return to hospital within 90 days.
  • Fewer revision surgeries – a lower chance of needing another hip operation soon after the first.
  • Reduced intraoperative bleeding – reducing the risk of a blood transfusion and its associated risks.
  • Reduced post-operative pain profiles – meaning more comfort post-operatively

What Does This Mean for Patients?
While both types of anaesthesia are safe, spinal anaesthesia is often associated with smoother recovery and fewer complications. For many patients, it may mean less time in hospital and an easier return to daily life.

That said, every patient is different. Your anaesthetist will consider your medical history, the complexity of your surgery, and your personal preferences when discussing the best option for you.

Key Takeaway
For most people having a hip replacement, spinal anaesthesia offers important benefits, including quicker recovery and fewer complications. However, both spinal and general anaesthesia are safe choices — your anaesthetist will work with you to find the approach that best fits your health and needs.

Reference
Memtsoudis SG, Cozowicz C, et al. J Arthroplasty. 2024;39(7):1231-1239.

 

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