DefinePK

Abstract

Background: Total knee replacement (TKR) is a commonly performed orthopedic procedure aimed at relieving pain and restoring joint function in patients with advanced knee pathology. The choice of anesthesia—regional anesthesia (RA) versus general anesthesia (GA)—has been shown to influence various recovery outcomes. RA is increasingly recognized for its potential to reduce postoperative pain, minimize systemic side effects, and accelerate rehabilitation. However, evidence comparing its effectiveness with GA remains inconsistent and context-specific.
Objective: To compare the effectiveness of regional versus general anesthesia in improving early postoperative outcomes—specifically pain, mobility, complications, and patient satisfaction—within 24 hours of knee replacement surgery.
Methods: A descriptive analytical study was conducted over six months at Jinnah Hospital, Lahore, involving 79 patients aged 50–80 years undergoing primary unilateral knee replacement. Participants were grouped based on anesthesia type: RA (n=45) and GA (n=34). Data were collected through hospital records and structured patient feedback forms. Pain was assessed using the Numeric Pain Rating Scale (NPRS) at 6, 12, and 24 hours postoperatively. Additional outcomes included mobility status, presence of complications (e.g., nausea, respiratory issues, infection), discharge readiness, and satisfaction with pain management. Data were analyzed using SPSS version 25, with a significance threshold of p<0.05.
Results: Patients receiving RA reported lower mean pain scores at 6 hours (4.72 ± 2.02), 12 hours (3.04 ± 1.57), and 24 hours (3.39 ± 1.87), compared to GA patients (6.74 ± 2.42, 4.26 ± 1.89, and 4.75 ± 2.76, respectively; p<0.05 for all). Mobility within 24 hours was achieved by 50.6% of participants, and 54.4% were discharge-ready. Additionally, 54.4% reported no nausea, while 53.2% experienced respiratory complications. Overall satisfaction with pain management was noted in 39.2% of cases.
Conclusion: Regional anesthesia was more effective than general anesthesia in enhancing early postoperative recovery in knee replacement patients, offering better pain control, fewer side effects, and faster ambulation. These findings support the broader use of RA in TKR procedures, though further research is needed to explore long-term benefits.