Comparing general and regional anesthesia in patients undergoing primary total hip arthroplasty: Analysis of national health insurance data in Korea

Seungyoung Lee ¹ Eunjin Ahn ^2,3* Min Kyoung Kim ^2,3 Fletcher A White ^4,5 Euiheon Chung ⁶ YongHun Chung ^2,3

• ¹ Chung-Ang University Hospital, Seoul, Republic of Korea
• ² Chung-Ang University Gwangmyeong Hospital, Gwangmyeonsi, Republic of Korea
• ³ College of Medicine, Chung-Ang University, Seoul, Republic of Korea
• ⁴ Stark Neurosciences Research Institute, School of Medicine, Indiana University Bloomington, Indianapolis, United States
• ⁵ Indiana University, Purdue University Indianapolis, Indianapolis, United States
• ⁶ Veterans Health Service Medical Center, Seoul, Republic of Korea

Objectives: To compare the effects of general and regional anesthesia on clinical outcomes following primary total hip arthroplasty (THA).Methods: This retrospective study using data from the Korean National Health Insurance Research Database included 1,522 patients who underwent THA under general anesthesia (n=640) or regional anesthesia (n=882) between 2002 and 2015. We compared the mortality and complication rates within 30 days after surgery.Results: Prosthesis failure (1.56% vs. 0.45%, P=0.025), admission to the intensive care unit (9.53 vs. 5.44%, P=0.0023), and total cost (₩7,332,515 vs. ₩6,833,295, P<0.0001) were higher in the general anesthesia group than in the regional anesthesia group. No significant differences were observed in mortality (0.94% vs. 0.57%, P=0.54), transfusion rate (81.1% vs. 80.9%, P=0.94), length of hospital stay (45 vs. 45 days, P=0.23), or other complications between the groups. Similar results were observed in propensity-score matched analysis (n=640 patients per group).Our study showed that both anesthesia types resulted in comparable mortality and complication rates in patients who underwent THA, but the costs differed.