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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 7, 935-942.
doi: 10.1302/0301-620X.91B7.21538  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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A comparison of regional and general anaesthesia for total replacement of the hip or knee

A META-ANALYSIS

S. Hu, MD, Orthopaedic Surgeon1; Z.-Y. Zhang, MD, Professor1; Y.-Q. Hua, MD, Orthopaedic Surgeon1; J. Li, MD, Orthopaedic Surgeon1; and Z.-D. Cai, MD, Professor1

1 Department of Orthopaedics, Changhai Hospital, Second Military Medical University, 168, Changhai Road, Shanghai, 200433, People’s Republic of China.

Correspondence should be sent to Professor Z.-D. Cai; e-mail: zhengdongcai1961{at}yahoo.cn

We performed a meta-analysis to evaluate the relative efficacy of regional and general anaesthesia in patients undergoing total hip or knee replacement. A comprehensive search for relevant studies was performed in PubMed (1966 to April 2008), EMBASE (1969 to April 2008) and the Cochrane Library. Only randomised studies comparing regional and general anaesthesia for total hip or knee replacement were included.

We identified 21 independent, randomised clinical trials. A random-effects model was used to calculate all effect sizes. Pooled results from these trials showed that regional anaesthesia reduces the operating time (odds ratio (OR) –0.19; 95% confidence interval (CI) –0.33 to –0.05), the need for transfusion (OR 0.45; 95% CI 0.22 to 0.94) and the incidence of thromboembolic disease (deep-vein thrombosis OR 0.45, 95% CI 0.24 to 0.84; pulmonary embolism OR 0.46, 95% CI 0.29 to 0.80).

Regional anaesthesia therefore seems to improve the outcome of patients undergoing total hip or knee replacement.




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A comparison of regional and general anaesthesia for total replacement of the hip or knee
Richard Brull, et al.
J Bone Joint Surg Br Online, 31 Jul 2009 [Full text]

(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General