General Versus Neuraxial Anesthesia in Revision Surgery for Periprosthetic Joint Infection

Background: The purpose of this study was to compare neuraxial and general anesthesia in revision surgery for periprosthetic joint infection (PJI).

Methods: Patients undergoing revision arthroplasty for PJI were identified in the 2005-2019 American College of Surgeons National Surgical Quality Improvement Program databases. Thirty-day outcomes were compared between general and neuraxial anesthesia. Propensity-score matching and multivariate analysis were used to control patient and procedural variables.

Results: Neuraxial anesthesia was used in 1511 (16.8%) cases and general anesthesia in 7468 (83.2%) cases. Neuraxial anesthesia had a lower risk of any adverse event (odds ratio [OR] 0.70, P < .001), serious adverse events (OR 0.77, P < .001), and minor adverse events (OR 0.66, P < .001). Among 875 reoperations and 1351 readmissions, two had a diagnosis of intraspinal abscess, both occurring after general anesthesia.

Conclusions: Neuraxial anesthesia was associated with a lower risk of adverse events when compared to general anesthesia in revision surgery for PJI.