title: Factors influencing the choice of anesthetic technique for primary hip and knee arthroplasty.
abstract: Despite evidence in the literature, continuing wide variation exists in anesthetic technique for primary joint arthroplasties. Recent evidence suggests that neuraxial anesthesia has advantages over general anesthesia in terms of mortality, major morbidity and healthcare utilization. Yet, despite the proposed benefits, utilization of these two techniques varies greatly across geographical locations, with general anesthesia being most common for total hip arthroplasty (THA) and total knee arthroplasty (TKA) in parts of the world. We uncover some factors that promote or hinder the use of neuraxial anesthesia in THA and TKA. Healthcare professionals should be familiarized with the evidence for neuraxial anesthesia, and unbiased educational material should be developed for patients regarding anesthetic options for THA and TKA in order to promote best practice.
authors.affiliation: Department of Anesthesiology, University of Ottawa, Ottawa, ON, Canada.|The Ottawa Hospital, General Campus, CCW 1401, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
authors.forename: Patrick B Y
authors.initials: PB
authors.lastname: Wong
authors.affiliation: Department of Anesthesiology, University of Ottawa, Ottawa, ON, Canada.|The Ottawa Hospital, General Campus, CCW 1401, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
authors.forename: Jason
authors.initials: J
authors.lastname: McVicar
authors.affiliation: Schulich School of Medicine & Dentistry, Western University, ON, N6G 2M1, Canada.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Nelligan
authors.affiliation: Department of Anesthesiology, University of Ottawa, Ottawa, ON, Canada.|The Ottawa Hospital, General Campus, CCW 1401, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
authors.forename: Joanne C
authors.initials: JC
authors.lastname: Bleackley
authors.affiliation: Department of Anesthesiology, University of Ottawa, Ottawa, ON, Canada.|The Ottawa Hospital, General Campus, CCW 1401, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
authors.forename: Colin J L
authors.initials: CJ
authors.lastname: McCartney
mesh_terms: D000767:Anesthesia, Epidural / Q000706:statistics & numerical data*; D000768:Anesthesia, General / Q000706:statistics & numerical data*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D014943:Global Health; D006801:Humans; D057240:Patient Preference; D016896:Treatment Outcome
keywords: anesthesia practice pattern; general anesthesia; hip arthroplasty; knee arthroplasty; neuraxial anesthesia; spinal anesthesia