title: Practice Variations in Anesthetic Care and Its Effect on Clinical Outcomes for Primary Total Hip Arthroplasties.
abstract: BACKGROUND
  Knowledge regarding anesthetic practice variations in the use of general anesthesia (GA) vs neuraxial anesthesia (NA) as primary anesthetics for a primary total hip arthroplasty is limited.
  
  
  METHODS
  A total of 107,490 cases were identified in the National Anesthesia Clinical Outcomes Registry, in which 31.7% and 68.3% were performed with NA and GA, respectively.
  
  
  RESULTS
  Resident presence, board-certification status, comorbidities, and case duration were associated with the implementation of NA vs GA. Neuraxial anesthesia was associated with decreased rates of extended recovery room stay, inadequate pain control, and postoperative nausea/vomiting.
  
  
  CONCLUSIONS
  Anesthetic technique differences were associated with patient and provider characteristics. Our results can help improve quality measures and identify areas that need improvement in cost reduction and efficiency within this specific surgical patient population.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts.
authors.forename: Rodney A
authors.initials: RA
authors.lastname: Gabriel
authors.affiliation: Department of Anesthesiology, LSU Health Sciences Center, New Orleans, Louisiana.
authors.forename: Alan D
authors.initials: AD
authors.lastname: Kaye
authors.affiliation: Department of Anesthesiology, LSU Health Sciences Center, New Orleans, Louisiana.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Jones
authors.affiliation: Anesthesia Quality Institute, Schaumburg, Illinois.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Dutton
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts. Electronic address: rurman@partners.org.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000765:Anesthesia, Conduction / Q000706:statistics & numerical data*; D000768:Anesthesia, General / Q000706:statistics & numerical data*; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012042:Registries; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: anesthesia variation; hip arthroplasty; neuraxial anesthesia; outcomes; regional anesthesia