Anesthetic practice and pattern for total hip and knee replacement in Canada: a 5 year cross-sectional study

Abstract

Purpose: The objective of the study was to examine choice of anesthesia for total hip arthroplasty (THA) and total knee arthroplasty (TKA) in different provinces of Canada over a five-year period.
bIn a retrospective, cross-sectional study, national data for patients undergoing THAs and TKAs between 1st April 2011 and 31st March 2016 was examined. The primary outcome was the anesthetic type used in the surgery, which was categorized as general, spinal, combined, or ‘other’. Total number and percentage of surgeries carried out using each anesthetic type were calculated per fiscal year, in non-teaching and TIs, in each Canadian province and territories, exclusive of Québec. Non-parametric statistics (Pearson Chi square tests) were used to compare the choice of anesthetic type by fiscal year and institution type.
Results: During the study period, neuraxial anesthesia (NA) was used for 74.7% of all THAs and 80.3% of all TKAs nationwide. In NTIs, 76.2% of THAs and 80.5% of TKAs were carried out with NA. This trend was similar to that within teaching hospitals, where 73.1% of THAs and 80.6% of TKAs were carried out with NA. Interprovincial comparisons demonstrated a greater preference for NA for both THAs and TKAs in majority of the provinces. There were no significant differences in anesthetic choice between teaching and NTIs.
Conclusion: Neuraxial anesthesia was the anesthesia of choice for THA and TKA during the entire study period in Canada, both in teaching and non-teaching institutions. During the study period, a majority of provinces showed a trend of increasing use of neuraxial anesthesia for both THA and TKA, with few exceptions.
Citation: Pandey M, Johnson K, Siddiqui MA. Anesthetic practice and pattern for total hip and knee replacement in Canada: a 5 year cross-sectional study. Anaesth pain & intensive care 2019;23(3):301-310