Postoperative complaints after spinal and thiopentone-isoflurane anaesthesia in patients undergoing orthopaedic surgery - Spinal versus general anaesthesia

Background. The present prospective study investigates the impact of a standardized technique of spinal and general anaesthesia on the incidence and consequences of postanaesthetic complaints dependent on age and sex of patients. Methods. 433 orthopaedic patients underwent lower limb surgery in spinal (group 1) or general (group 2) anaesthesia. Spinal anaesthesia was performed with 0.5% hyperbaric bupivacaine using a 26-gauge Quincke needle. General anaesthesia was induced with i.v. injection of thiopentone, fentanyl and atracurium and maintained with 65% nitrous oxide and 1-1.5 Vol% isoflurane in oxygen. On postoperative day 4, patients were interviewed for onset and duration of postoperative complaints. Results. The overall incidence of nausea/vomiting (P=0.025) and sore throat (P=0.0001) was higher in group 2. In addition, nausea/vomiting was higher in patients between 20 and 60 years in group 2 compared with group 1. While the incidence of urinary dysfunction was higher in men after spinal (P=0.04), nausea/vomiting was more frequent in women after general anaesthesia (P=0.008). Analgetic requirements (P=0.013), time of postoperative surveillance (P=0.042) and frequency of treatment of postoperative complaints (P=0.0001) was higher in group 2. Conclusion. Spinal anaesthesia was associated with a lower incidence of postoperative complaints and treatments and a shorter surveillance compared to general anaesthesia. Specific complications related to spinal anaesthesia did not depend on age or sex and may allow for recommendation of this technique even in younger and female patients undergoing orthopaedic surgery.