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Anesthesia type affects outcomes of bilateral knee replacement surgery
Date:10/26/2012

Using regional anesthesia rather than general anesthesia reduces the need for blood transfusions in patients undergoing bilateral total knee replacement, according to a new study by researchers at Hospital for Special Surgery, in New York City.

Currently, the majority of bilateral knee replacements in the United States (as well as single knee replacements) are performed under general anesthesia, and researchers say that a regional anesthesia known as neuraxial anesthesia should be promoted for these procedures.

"The use of neuraxial anesthesia may not always be feasible in every patient, but it should be considered more frequently," said Stavros Memtsoudis, M.D., Ph.D., director of Critical Care Services at Hospital for Special Surgery (HSS) in New York City, who led the study. "You shouldn't be asking doctors who don't use neuraxial anesthesia in their daily practice to suddenly switch over and start doing it, but there is a lot of education that needs to be done in terms of training residents and orthopedic surgeons to point out the impact of the choice of anesthetic technique on outcomes beyond the operating room." The study appears online ahead of print in the journal Regional Anesthesia and Pain Medicine.

Despite its advantages, bilateral knee replacement is associated with an increased risk of complications, compared with the alternative of operating on one knee at a time. Neuraxial anesthesia involves injecting medication into the fatty tissue that surrounds the nerve roots in the spine (known as an epidural) or into the cerebrospinal fluid that surrounds the spinal cord.

For the last two decades, HSS has increasingly used regional anesthesia for orthopedic procedures, because of a growing body of evidence showing favorable results compared with general anesthesia.

Because the influence of anesthesia on perioperative outcomes after bilateral total knee replacement is unknown, researchers at Hospital
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Contact: Phyllis fisher
phyllis.fisher@gmail.com
212-606-1724
Hospital for Special Surgery
Source:Eurekalert  

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