Hong Kong Med J 2006;12:442-7 | Number 6, December 2006

Postoperative outcome in Chinese patients having primary total knee arthroplasty under general anaesthesia/intravenous patient-controlled analgesia compared to spinal-epidural anaesthesia/analgesia

CPW Chu, JCCM Yap, PP Chen, HH Hung

Knee

OBJECTIVE. To compare postoperative outcomes in patients having primary total knee arthroplasty receiving general or regional anaesthesia.

DESIGN. Randomised prospective study.

SETTING. Regional hospital, Hong Kong.

PATIENTS. Patients having primary total knee replacement were randomised to either general anaesthesia followed by postoperative intravenous patient-controlled analgesia with morphine, or combined spinal-epidural anaesthesia followed by postoperative epidural infusion of bupivacaine 0.1% with fentanyl 2 micrograms/mL.

MAIN OUTCOME MEASURES. Visual analogue scale pain scores, perioperative blood loss, time to first meal and ambulation, and prevalence of postoperative complications.

RESULTS. Sixty consecutive patients were enrolled in this study. Postoperative median pain scores were consistently lower at 1 (P

CONCLUSION. Chinese patients undergoing total knee arthroplasty with regional anaesthesia/regionally delivered analgesia enjoyed better postoperative pain relief and resumed meals earlier than those receiving general anaesthesia/intravenous patient-controlled analgesia. The former also showed trends towards less adverse effects, postoperative complications, earlier ambulation, and earlier hospital discharge.

Key words: Analgesia, epidural; Analgesia, patient-controlled; Anesthesia, general; Anesthesia, local; Arthroplasty, replacement, knee

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