Comparison of general and epidural anesthesia in patients undergoing primary unilateral THR

One hundred ninety-five consecutive patients underwent 195 primary unilateral total hip arthroplasties between January 1988 and December 1993. Patients were divided into three groups based on the type of anesthesia utilized for their procedure. Group I consisted of 108 patients (59 women and 49 men; average age 56 years) who had general endotracheal anesthesia alone. Group II consisted of 70 patients (41 women and 29 men, average age 58 years) who had general endotracheal anesthesia with epidural augmentation intraoperatively and postoperatively. Group III consisted of 17 patients (6 women and 11 men, average age 62 years) who had epidural anesthesia only. Data were analyzed by anesthesia group to compare a variety of clinically relevant factors. No statistically significant differences among groups were noted regarding average age at surgery, the underlying diagnoses leading to joint replacement, the number of preexisting medical conditions, length of hospitalization, nonsurgical operating room time, intraoperative blood transfusions, intraoperative femur fractures, deep venous thrombosis, deep infections, death, or the prevalence of postoperative urinary tract infections. Postoperative urinary tract infections correlated with duration of Foley catheterization, but not the duration of epidural catheterization. Significant differences among anesthesia groups were observed for two factors: 1) estimated intraoperative blood loss was highest for Group I (P < .05) and was primarily a function of surgical time (P < .0001), and 2) postoperative Hemovac output (over the first and second postoperative 24-hour periods) was greatest for Group II (P < .05). Epidural anesthesia appears to be a safe modality in patients undergoing primary unilateral total hip replacement.