Does spinal anesthesia increase the pain and anxiety after total knee arthroplasty? a randomized prospective study

In this study, postoperative pain and anxiety level of the patients who were scheduled for spinal anesthesia (SA) and remained awake during the operation and patients who were scheduled for general anesthesia (GA) and were asleep during the operation were assessed.

Thirty-six patients who underwent total knee arthroplasty in our clinic were randomly divided into two groups. The first group (SA group) was given spinal anesthesia during operation (heavy marcaine), while the second group (GA group) underwent general anesthesia (propofol + nitric oxide). Hospital anxiety-depression (HAD) scores and visual analog scale (VAS) scores of the patients were calculated postoperatively. The patients were asked to score anxiety by the physicians.

The mean postoperative HAD score was 24.68 in GA group, and 29.62 in SA group (p>0.05). The physicians score for patients' anxiety after surgery was 1.05 in GA group, and 1.69 in SA group (p<0.05). The mean postoperative VAS of the patients was 8.42 in GA group, and 8.87 in SA group (p>0.05). No statistically significant differences were found between the SA group and GA group in terms of HAD scores. No significant differences were found between the mean postoperative VAS scores of the groups. A statistically significant difference was found between the two groups for the physician's score for patients' postoperative anxiety.

Our study results showed that total knee arthroplasty under spinal anesthesia was not associated with mood changes in patients and no increase in postoperative pain was seen.