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

Abstract

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). Conclusion: Our study showed that both anesthesia types resulted in comparable mortality and complication rates in patients who underwent THA, but the costs differed.