Purpose
We sought to identify the immediate postoperative differences in opioid use, pain
scores, and post-anesthesia care unit (PACU) length of stay (LOS) after hip arthroscopy
related to the type of anesthesia used for the surgical procedure.
Methods
Patients undergoing hip arthroscopy for femoroacetabular impingement syndrome with
labral tears by a single surgeon at an academic center between October 2017 and July
2019 were reviewed retrospectively. The primary outcome was PACU opioid administration,
measured by morphine equivalents. Secondary parameters included total LOS, postincision
LOS, PACU LOS, and PACU arrival/discharge pain scores. Analyses conducted were t tests, Wilcoxon rank sum tests, or χ2 tests.
Results
A total of 129 patients met inclusion criteria for this study; 54 male and 75 female,
with an average age of 28 (±10.1) years. In total, 52 (40.3%) had general anesthesia
and 77 (59.7%) had neuraxial anesthesia, including spinal, epidural, and combined
spinal-epidural anesthesia, which were intermixed throughout the study period. Intraoperative
and PACU opioid administration demonstrated a significant difference in medians. Neuraxial
methods required a lower morphine equivalents in both the operating room (30.0 vs
53.9, P = .001) and PACU (18.2 vs 31.2, P = 0.002). Neuraxial anesthesia had lower median PACU arrival and discharge pain scores
(0.0 vs. 5.0, P = .001, 3.0 vs. 4.0, P = .013). There was no statistically significant difference in postincision LOS or
traction time. General anesthesia was associated with a longer PACU phase 1 time (1.0
vs 1.3 hours, P = .005). No major adverse events such as death, disability, or prolonged hospitalization
occurred in either group.
Conclusions
Neuraxial anesthesia use in routine hip arthroscopy was associated with lower immediate
postoperative pain scores, lower intraoperative and immediate postoperative opioid
requirements, and may be associated with shorter anesthesia recovery time without
any major adverse events when compared with general anesthesia.
Level of Evidence
III, Retrospective Comparative Study
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Article Info
Publication History
Published online: November 17, 2020
Accepted:
August 22,
2020
Received:
March 19,
2020
Footnotes
See commentary on page 147
The authors report the following potential conflicts of interest or sources of funding: K.M.S. reports other from American Society of Regional Anesthesia and Pain Medicine – ASRA News Editor, Communications Committee, and nonfinancial support from Wright Medical Technology, outside the submitted work. A.M.S. reports personal fees and nonfinancial support from Stryker and nonfinancial support and other from Great Lakes Orthopedics, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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