Regional anesthesia with propofol sedation versus general anesthesia in unilateral total knee arthroplasty patients.

This retrospective cohort study examined 250 patients undergoing unilateral total knee arthroplasty. The intervention involved regional anesthesia with monitored anesthesia care (RA), comprising spinal anesthesia and peripheral nerve blocks with propofol titrated to maintain mild sedation and spontaneous ventilation. The comparator was general anesthesia alone. The primary outcome assessed was the incidence of in-hospital deep vein thrombosis (DVT), with secondary outcomes including pulmonary embolism, readmissions, ambulation time, length of stay, pain scores, opioid consumption, D-dimer levels, and complications.

Regarding thrombotic outcomes, there was no significant difference in the overall incidence of postoperative DVT between the RA and general anesthesia groups (p > 0.05). Similarly, the incidence of symptomatic pulmonary embolism did not differ significantly between the two groups (p > 0.05).

In contrast, the RA group showed favorable outcomes in several secondary metrics. Readmission rates within 30 days were significantly lower in the RA group compared to the general anesthesia group. Additionally, the time to first ambulation was earlier, and the duration of hospital stay was shorter for patients receiving regional anesthesia. Data regarding pain scores, opioid consumption, and D-dimer levels were not reported in the provided evidence.

Safety and tolerability data, including specific adverse events, serious adverse events, discontinuations, and tolerability metrics, were not reported in the input. As this is an observational study, the findings regarding readmissions and recovery metrics should be interpreted with caution regarding causal inference. The study limitations were not explicitly detailed in the provided text. These results suggest potential benefits for regional anesthesia in this specific surgical population, but further research is needed to confirm these associations.