Effects of Inhalation Anesthesia vs. Total Intravenous Anesthesia (TIVA) vs. Spinal-Epidural Anesthesia on Deep Vein Thrombosis After Total Knee Arthroplasty

Abstract

BackgroundThe objective of the present study was to evaluate the varying efficacy of general anesthesia (GA), combined spinal-epidural anesthesia (CSEA), and total intravenous anesthesia (TIVA) on the occurrence of deep vein thrombosis (DVT) following total knee arthroplasty (TKA).Material/MethodsFrom July 2013 to May 2015, a total of 197 cases of patients who had undergone TKA treatment at either the Drum Tower Hospital or Nanjing General Hospital of Nanjing Military Command were recruited to participate in the study. The patients in the study were separated into 3 groups depending on the anesthesia approach received: the GA group, the CSEA group, and the TIVA group. The baseline characteristics and relative parameters of patients were monitored before and after surgery for analytic purposes. A 3-month follow-up after surgery was conducted to observe the rate of DVT occurrence and any DVT-related complications.ResultsThe TIVA group exhibited significant decreases in relation to the swallowing time reflex, extubation, and consciousness recovery in comparison to other groups in the study. Additionally, platelet count was significantly decreased and there was drastic extension of the activated partial thromboplastin time (APTT) in the CSEA group and the TIVA group. There were clear differences in the incidence of DVT and its complications among the 3 groups. The TIVA group displayed the lowest incidences of DVT and DVT-related complication during the study. Based on logistic regression analysis, the type of anesthesia was utilized as an independent correlative factor for the occurrence of DVT after surgery.ConclusionsThe results obtained during the study established a clinical basis for comparative analysis of various anesthesia methods. We found that, compared with GA and CSEA, patients undergoing TIVA had a reduced rate of risk in relation to the occurrence of DVT following TKA.

Does diabetes mellitus increase the incidence of early thrombosis in deep vein following unicompartmental knee arthroplasty: a retrospective cohort study

“…However, since the admission records did not distinguish the type of diabetes, the influence of the type on DVT needs to be further studied. Third, different anesthetic methods exert different influences on hemodynamics, thus affecting the occurrence of postoperative DVT [ 30 ]. In our study, all patients received general or intraspinal anesthesia, and no significant difference was observed between them ( p = 0.716).…”

Epidural Anesthesia versus General Anesthesia for Total Knee Arthroplasty: Influences on Perioperative Cognitive Function and Deep Vein Thrombosis

“…Furthermore, we found a statistically lower incidence of DVT in RG compared with CG (9.46% vs. 24.00%), suggesting that EA can reduce the risk of DVT in TKA patients, which is similar to the findings of Hafezi et al [ 17 ]. EA may reduce the risk of DVT development by preventing postoperative hypercoagulability, thus reducing postoperative thromboembolic complications [ 28 ]. Other studies have shown that under EA, anaesthetics are absorbed into the blood through the epidural space, which can inhibit the aggregation, release, and adhesion of platelets and improve the coagulation function of patients [ 29 ].…”

Does diabetes mellitus increase the occurrence of early thrombosis in deep vein following unicompartmental arthroplasty of the knee: a retrospective cohort study

“…Second, we do not distinguish between the types of diabetes, and different types of diabetes may have different effects on DVT. Third, different anesthetic methods exert different influence on hemodynamics, thus affecting the occurrence of postoperative DVT [31]. In this study, all patients received general or intraspinal anesthesia, and no significant difference was observed between them (p=0.940).…”