The Effects of Spinal Anesthesia on Inpatient Length of Stay
Total knee arthroplasty (TKA) is one of the most common procedures performed on adults aged 45 and over. According to the National Center for Health Statistics, from 2000 through 2010 an estimated 5.2 million total knee replacements on adults over the age of 45 were performed (Williams, Wolford, & Bercovitz, 2015). Within this population, the patient’s length of stay (LOS) is an important indicator of postoperative outcomes and risk for further complications. A patient’s post-operative outcomes such as LOS is influenced by many factors including the type of anesthesia provided. A review of published literature was conducted to analyze the relationship between types of anesthesia and the patient's LOS within adults between the ages of 45 and 80 receiving a TKA. The types of anesthesia examined for their effect on LOS and risk for complications were spinal anesthesia (SA) and general anesthesia (GA). The purpose of this Evidence Based Practice review is to determine whether SA decreases the LOS and risk for complications in comparison to GA. Specifically, health care providers and specialty nurses such as Certified Registered Nurse Anesthetists can use this information to address various benefits and risks associated with the different types of anesthesia (SA and GA) for TKAs with the support of evidence-based practice. Additionally, by identifying factors that may decrease LOS, healthcare professionals can assess the quality of patient care, examine the effectiveness of hospital management, and decrease overall national medical expenses.