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A Retrospective Study of Anesthetic Considerations in Hip Arthroscopy: Regional versus General

Open Journal of Anesthesiology 2018年第12期8卷 295-304页

作者： Molly Kraus Brittany Foley Lopa Misra david hartigan Marlene Girardo david Seamans Department of Anesthesiology Mayo Clinic Phoenix Arizona USA Department of Orthopedic Surgery Mayo Clinic Phoenix Arizona USA Department of Health Sciences Research Division of Biostatistics Mayo Clinic Phoenix Arizona USA

Purpose: Hip arthroscopy is a surgery with favorable outcomes to treat labral tears of the hip. This retrospective review was conducted to identify an optimal anesthetic technique for hip arthroscopy to minimize postoperative pain and decrease opioid consumption. Methods: A retrospective analysis was performed for 92 patients who underwent hip arthroscopy for femoroacetabular impingement (FAI) with labral tear under general anesthesia (G) with fascia-iliaca block (64 patients) or regional anesthesia (R) with fascia-iliaca block (28 patients) from March 9, 2016 to April 9, 2018. Data collected included: demographics, diagnosis, ASA status, time in surgery, medications administered, type of anesthesia administered, pain scores, use of straight catheter, and time in PACU. Results: Patients who underwent hip arthroscopy under regional anesthesia reported significantly less first (G: 3.4 (3.9), R: 1.3 (3.0), p = 0.0085) and average (G: 3.8 (2.5), R: 2.0 (2.2), p = 0.0038) pain post-operatively. Patients under regional anesthesia also received less total morphine milligram equivalents (MME) intraoperatively and post-operatively (G: 40.8 (21.7) MME, R: 24.9 (17.8), p = 0.004 MME). Patients under regional anesthesia had a significantly higher incidence of urinary retention (G: 3.1%, R: 28.6%, p = 0.009) and increased time spent in PACU (G = 181.9 (86.3), R: 251.4 (80.4), p = 0.0001). Conclusions: The administration of regional anesthesia resulted in significantly lower pain scores and perioperative opioid consumption compared to general anesthesia in patients undergoing hip. This may be the optimal anesthetic technique for pain control;however, incidence of urinary retention and time to discharge are significantly increased. Prospective randomized control trials are needed to compare general anesthesia and regional anesthesia for hip arthroscopy.

关键词： Anesthesia Hip Arthroscopy Perioperative Management Regional Spinal

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