Patients undergoing total knee or hip replacements may see lower healthcare costs at hospitals that use neuraxial anesthesia as the primary anesthetic, new study data indicates.

The new research – conducted by conducted by anesthesiologists at Hospital for Special Surgery (HSS) in conjunction with researchers at other institutions, and presented at the annual meeting of the American Society of Regional Anesthesiologists (ASRA) reported the rates of adverse outcomes such as respiratory and cardiac complications, and hospitalization costs, in patients undergoing lower joint replacements. By analyzing data from 766,100 total knee replacement patients and 354,894 total hip replacement patients enrolled in the Premier Perspective database from 2006 to 2014, the authors found that hospitals that used neuraxial anesthesia in 49 percent to 97 percent of lower joint replacement cases were associated with a 24 percent decreased odds for respiratory and cardiac complications compared to hospitals that used neuraxial anesthesia in zero percent to four percent of lower joint replacement cases. Moreover, compared with hospitals with the lowest neuraxial anesthesia use, hospitals with the highest volume were associated with decreased hospitalization costs: –19 percent and –17 percent in total knee and hip replacements, respectively.

"Hospitals that use neuraxial anesthesia (versus those that don’t), are associated with lower hospitalization cost for lower joint replacements," commented Stavros Memtsoudis, MD, PhD, lead author and senior researcher in the Department of Anesthesiology at HSS. "This may be partly due to lower odds for adverse outcomes, particularly in total knee replacement patients; use of neuraxial anesthesia utilization on a hospital level may very well emerge as an important marker of quality; however, additional studies are needed to elucidate all drivers associated with perioperative outcomes."