Arthroscopy - 2026-09-25 - Journal Article
Short-Term Clinical and Patient-Reported Outcomes Are Similar for Neuraxial Compared With General Anesthesia for Hip Arthroscopy.
Beyer RSH, Nitz JN, Dhawan A, Collinson ER, Mosiman SJ, Spiker AM
Topics
Key Takeaway
Neuraxial anesthesia for hip arthroscopy reduces intraoperative and PACU narcotic consumption but produces equivalent 2-year PROs and revision rates (3.8%) compared to general anesthesia.
Summary Depth
Choose how much analysis to show on this article page.
Summary
This retrospective study compared neuraxial versus general anesthesia in 159 hip arthroscopies for FAI syndrome, assessing clinical complications, revision rates, and PROs (iHOT-12, mHHS, HOS-ADL, HOS-SS) at minimum 2-year follow-up. Neuraxial anesthesia reduced intraoperative and PACU narcotic administration and PACU admission pain scores but extended total surgical length of stay due to longer PACU phase 2 times. Anesthesia type did not affect complication rates (P=0.33), revision rates (P>0.7), or likelihood of achieving MCID on any PRO scale (P=0.15).
Key Limitation
Non-randomized design with no documentation of the criteria driving anesthesia selection creates unmeasured confounding that cannot be adjusted for retrospectively.
Original Abstract
PURPOSE
To compare the short-term clinical and patient-reported outcomes (PROs) in patients who received neuraxial anesthesia versus general anesthesia for hip arthroscopy to treat femoroacetabular impingement syndrome at a minimum of 2 years postoperatively.
METHODS
Patients undergoing isolated hip arthroscopy to address femoroacetabular impingement syndrome from October 2017 to February 2022 with 2-year postoperative PRO data were retrospectively reviewed. PROs were obtained from an Institutional Review Board-approved hip preservation registry. Primary outcomes were postoperative clinical complications (e.g., paresthesia), revision hip arthroscopy, conversion to periacetabular osteotomy or total hip arthroplasty, and PRO measures including the International Hip Outcome Tool-12, modified Harris Hip Score, Hip Outcome Score-Activities of Daily Living, and Hip Outcome Score-Sports Specific subscale scores. Intraoperative and postanesthesia care unit (PACU) times and narcotic administration were also recorded.
RESULTS
A total of 159 hips (141 patients) met inclusion criteria consisting of 109 women (68.6%) and 50 men (31.4%). Average age at surgery was 32.0 years (range, 13-60 years). A total of 103 surgeries (64.7%) were performed with neuraxial anesthesia, and 56 surgeries (35.2%) were performed with general anesthesia. Neuraxial anesthesia was associated with decreased intraoperative (P < .001) and PACU (P = .013) narcotic administration, decreased pain at PACU admission (P = .0002), and longer total surgical length of stay (P = .0002) because of longer PACU phase 2 times (P < .001). Almost all reported complications were cutaneous nerve paresthesias. Six patients (3.8%) underwent revision arthroscopy. Anesthesia type had no effect on whether a complication was reported (P = .33) or a revision was performed (P > .7). PRO scores increased for all scales over the postoperative period for both anesthesia groups, and anesthesia type did not increase the likelihood that a patient would achieve the minimal clinically important difference in any postoperative interval (P = .15).
CONCLUSIONS
Patients undergoing neuraxial anesthesia for hip arthroscopy to treat femoroacetabular impingement syndrome with concomitant labral tears have similar postoperative clinical outcomes and PRO scores to those who undergo general anesthesia for the procedure at short-term follow-up. Neuraxial anesthesia is thus an effective alternative to general anesthesia for hip arthroscopy patients.
LEVEL OF EVIDENCE
Level III, retrospective comparative study.