Comparison of Total Intravenous Anesthesia (TIVA) Versus Spinal Anesthesia in Total Knee Arthroplasty (TKA)

Mirza Hamid Beg; Khalid  Buland; Muhammad Huzaifa  Sharif; Shahzada  Irfan; Taimur Azam  Khan; Osama Abdul  Mateen

doi:10.51253/pafmj.v76iSUPPL-3.9593

Authors

Mirza Hamid Beg Department of Anesthesia, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Khalid Buland Department of Anesthesia, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Muhammad Huzaifa Sharif Department of Anesthesia, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Shahzada Irfan Department of Anesthesia, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Taimur Azam Khan Department of Anesthesia, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Osama Abdul Mateen Department of Anesthesia, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-3.9593

Keywords:

Postoperative pain; Propofol ; Spinal anesthesia; Total knee arthroplasty

Abstract

Objective: To assess outcomes of two anesthesia techniques utilized in total knee arthroplasty (TKA): total intravenous anesthesia (TIVA) and spinal anesthesia.

Study Design: Prospective Comparative Study.

Place and Duration of Study: Orthopedics Department, Combined Military Hospital, Rawalpindi, Pakistan, from May to Nov 22.

Methodology: A total of 78 patients, aged <75 years and with end-stage osteoarthritis, underwent TKA by either TIVA or spinal anesthesia. Individuals with medical comorbidities were excluded. Spinal anesthesia was provided by means of 0.5% bupivacaine, whereas TIVA was administered by using Propofol plus Remifentanil. A visual analogue scale (VAS) was applied to assess postoperative pain. Postoperative complications, e.g., nausea, vomiting, dizziness, postural drop, and deep venous thrombosis (DVT) were monitored for both groups. SPSS-23.0 was used to conduct statistical analysis, while a p-value<0.05 was considered significant.

Results: Thirty-eight patients (48.7%) underwent TIVA, while the remaining 40 cases (51.3%) were treated with spinal anesthesia. The mean age of the former group was 67.4±4.3 years and 66.5±4.7 years for spinal anesthesia. TIVA was capable of significantly lowering the incidence of postoperative pain (p=0.023). The median VAS was 5.0 (IQR: 2.0) for the TIVA and 6.0 (IQR: 2.0) for the spinal anesthesia group. A higher incidence of postoperative dizziness was reported during recovery from spinal anesthesia (n=22; 52%) as compared to TIVA (n=13; 34.2%). No significant difference was observed in terms of nausea/vomiting, postural drop, or DVT during patient recovery. Additionally, hospital stay also remained uniform in both groups.

Conclusion: TIVA is a potentially suitable candidate for the ..

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