Journal article
Comparison of conventional and robotic knee arthroplasty results: A retrospective observational study
Acta orthopaedica et traumatologica turcica, Vol.57(5), pp.277-282
09/01/2023
DOI: 10.5152/j.aott.2023.23120
PMCID: PMC10724807
PMID: 37861248
Abstract
Objective: This study aimed to determine whether a standard anesthetic protocol consisting of combined spinal epidural anesthesia (CSEA) in conjunction with controlled hypotensive anesthesia (CHA), which was used for conventional total knee arthroplasty (cTKA), could provide equally effective anesthetic conditions for robotic total knee arthroplasty (rTKA).Methods: Data were collected from the medical records of 113 patients (median age = 67 years; age range = 55-84) who underwent elective unilateral cTKA (n = 52) or rTKA (n = 61) without a tourniquet from 2021 to 2023. The primary outcome measure was the rate of patients whose anesthetic method did not provide adequate motor and sensory block during the surgery and had to be converted to general anesthesia. The secondary outcome measure was to compare perioperative variables, including pain scores, analgesic consumption, blood loss, transfusions, and complications.Results: In 6 patients (11.5%) in group rTKA, it was required to convert CSEA to general anesthesia at 160-180 minutes due to the pain at the operative knee and/or to the movement of the operative leg during surgery compared to none / zero in group cTKA (P = .008). Motor and sensory blocks terminated earlier than the total surgery time in those patients. Mean total surgery time was significantly higher in group rTKA than in group cTKA (151.25 +/- 24.51 (120-240) minutes vs. 116.72 +/- 4.99 (105-125) minutes, P < .001). Total surgery times tended to decrease gradually in group rTKA after the 11th case, indicating a learning curve for surgical performance. Conversion to general anesthesia was required only in 1 patient after the 11th case compared to the previous 5 patients. Mean pain scores and rescue analgesic consumption were higher in group rTKA at postoperative 0 hour and between 0 and 4 hours (P < .05) but similar at the following time points (P > .05). Blood loss, transfusion, and complication rates were similar (P > .05). Hospital discharge times were higher in group rTKA (P < .05).Conclusion: Although our standard CSEA protocol failed due to the regression of motor and sensory block during surgery in 11.5% of patients in rTKA, the CSEA technique combined with controlled hypotensive anesthesia provided similar anesthetic conditions in the remaining patients in group rTKA as in group cTKA. The CSEA may be considered an effective and safe anesthetic method for rTKA if interventions are applied to extend the duration of the CSEA for this novel surgical technique.
Details
- Title: Subtitle
- Comparison of conventional and robotic knee arthroplasty results: A retrospective observational study
- Creators
- Mehmet Anil Suzer - Türk Anesteziyoloji ve Reanimasyon DerneğiErdem Sahin - Çankaya UniversityMehmet Ozgur Ozhan - Türk Anesteziyoloji ve Reanimasyon DerneğiUmut Kara - Ankara
- Resource Type
- Journal article
- Publication Details
- Acta orthopaedica et traumatologica turcica, Vol.57(5), pp.277-282
- Publisher
- Turkish Assoc Orthopaedics Traumatology
- DOI
- 10.5152/j.aott.2023.23120
- PMID
- 37861248
- PMCID
- PMC10724807
- ISSN
- 1017-995X
- eISSN
- 2589-1294
- Number of pages
- 111
- Language
- English
- Date published
- 09/01/2023
- Academic Unit
- Anesthesia
- Record Identifier
- 9984656611002771
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