Regional Versus General Anesthesia in Total Hip Arthroplasty: A Meta-analysis of Randomized Controlled Trials
Poster #: 082
Session/Time: A
Author:
Benjamin Edward Johnson, BS
Mentor:
Melissa Rusli, BS, MD
Research Type: Clinical Research
Abstract
INTRODUCTION:
The anesthetic technique used during total hip arthroplasty (THA) can significantly influence postoperative outcomes such as pain control, opioid use, and hospital length of stay (LOS). Previous studies have produced inconsistent findings, and prior meta-analyses often included mixed or non-elective procedures, limiting applicability to elective THA. This meta-analysis evaluates whether regional anesthesia (RA) provides measurable advantages over general anesthesia (GA) in adult patients undergoing elective primary THA.
METHODS:
A systematic review and meta-analysis were conducted following PRISMA guidelines. We searched PubMed, Embase, and Cochrane CENTRAL (2015-2025) for randomized controlled trials comparing RA and GA in elective THA. Outcomes included postoperative pain scores, opioid consumption, and hospital LOS. A random-effects model was used to pool mean differences. Risk of bias was assessed using the Cochrane RoB 2.0 tool.
RESULTS:
Eleven RCTs encompassing 894 patients were included. RA was associated with significantly lower pain scores (mean difference -1.42 VAS units; 95% CI: -1.67 to -1.17), reduced opioid use (-6.26 morphine milligram equivalents; 95% CI: -7.15 to -5.36), and shorter hospital LOS (-1.07 days; 95% CI: -1.24 to -0.90). Risk of bias was generally low across studies. Moderate heterogeneity was observed and attributed to differences in RA technique and perioperative protocols.
CONCLUSION:
Regional anesthesia offers superior outcomes compared to general anesthesia for elective THA, with significant reductions in postoperative pain, opioid use, and hospital stay. These findings support the use of RA as a preferred anesthetic approach in hospital settings aiming to optimize recovery and resource utilization.
The anesthetic technique used during total hip arthroplasty (THA) can significantly influence postoperative outcomes such as pain control, opioid use, and hospital length of stay (LOS). Previous studies have produced inconsistent findings, and prior meta-analyses often included mixed or non-elective procedures, limiting applicability to elective THA. This meta-analysis evaluates whether regional anesthesia (RA) provides measurable advantages over general anesthesia (GA) in adult patients undergoing elective primary THA.
METHODS:
A systematic review and meta-analysis were conducted following PRISMA guidelines. We searched PubMed, Embase, and Cochrane CENTRAL (2015-2025) for randomized controlled trials comparing RA and GA in elective THA. Outcomes included postoperative pain scores, opioid consumption, and hospital LOS. A random-effects model was used to pool mean differences. Risk of bias was assessed using the Cochrane RoB 2.0 tool.
RESULTS:
Eleven RCTs encompassing 894 patients were included. RA was associated with significantly lower pain scores (mean difference -1.42 VAS units; 95% CI: -1.67 to -1.17), reduced opioid use (-6.26 morphine milligram equivalents; 95% CI: -7.15 to -5.36), and shorter hospital LOS (-1.07 days; 95% CI: -1.24 to -0.90). Risk of bias was generally low across studies. Moderate heterogeneity was observed and attributed to differences in RA technique and perioperative protocols.
CONCLUSION:
Regional anesthesia offers superior outcomes compared to general anesthesia for elective THA, with significant reductions in postoperative pain, opioid use, and hospital stay. These findings support the use of RA as a preferred anesthetic approach in hospital settings aiming to optimize recovery and resource utilization.