Does Total Intravenous Anesthesia With Short-acting Spinal Anesthetics in Primary Hip and Knee Arthroplasty Facilitate Early Hospital Discharge?

Abstract

Our study assessed the effect of total intravenous anesthesia (TIVA) with short-acting spinal anesthesia and aggressive day-of-surgery postoperative day 0 physical therapy (POD#0 PT) on hospital length of stay (LOS) in patients who underwent primary total joint arthroplasty. A retrospective chart review compared the hospital LOS of 116 patients who underwent primary total hip arthroplasty and total knee arthroplasty with TIVA and short-acting spinal blockade ("Updated protocol group") with that of the control group of 228 patients who were under standard anesthesia ("Traditional protocol group"). Both total hip arthroplasty and total knee arthroplasty patients in the Updated protocol group had markedly reduced LOS compared with those in the Traditional protocol group (1.5 ± 0.1 days versus 2.4 ± 0.1 days; P < 0.05 and 1.4 ± 0.1 days versus 2.3 ± 0.1 days; P < 0.05). A higher proportion of patients in the Updated protocol group received at least 1 POD#0 PT session compared with those in the Traditional protocol group. Total intravenous anesthesia combined with short-acting spinal anesthetics provided the following benefits for patients who underwent primary total joint arthroplasty: more day-of-surgery PT sessions and earlier discharge by nearly 1 full day. III.