Background: The widespread use of total knee arthroplasty(TKA) to treat patients who suffer knee osteoarthritis(KOA) has led to a number of postoperative problems, including the recovery of postoperative quality of life and postoperative delirium(POD). Both problems could cause profound damages to patients and their families. This study assessed and compared the effects of total intravenous anesthesia with propofol versus inhalational anesthesia (sevoflurane) on postoperative quality of life and POD in patients who underwent TKA.
Methods: One hundred and fifty patients American Society of Anesthesiologists(ASA) I-III were assessed for inclusion in this study, and randomly divided into inhalational anesthesia with sevoflurane group(group S), and total intravenous anesthesia with propofol group(group P). The primary outcome was postoperative quality of life and secondary outcome was POD.
Results: The quality of life at the first month after surgery in group S was better than that in group P(P=0.02). However, there was no significant difference in quality of life between the two groups at 1 day before surgery, 1 day after surgery, 3 days after surgery, 7 days after surgery and 3 months after surgery. In group P, 19 patients (31.1%) had no anxiety/depression problems, 40 patients (65.6%) had moderate problems, and 2 patients (3.3%) had severe problems.In group S, 37 patients (60.6%) had no problems in anxiety/depression, 23 patients (37.7%) had moderate problems, and 1 patient had severe problems (1.7%). These two outcomes had significant differences (P=0.005) .The incidence of POD within 3 days after surgery was 24.6% (15/61) in group P and 36.1% (22/61) in group S. There was no significant difference in the incidence of POD between the two groups (P=0.17).
Conclusions: Group S patients have a better quality of life at the first month after surgery in comparison with those in group P regarding anxiety/depression. However, there were no significant differences in the quality of lives between the two groups at 1 day before surgery, 1 day after surgery, 3 days after surgery, 7 days after surgery, and 3 months after surgery. There was also no significant difference in POD. Thus, we concluded that both anesthetic technologies could be extensively used for TKA.
Trial registration: This trial was registered at the Chinese Clinical Trial Registry (ChiCRT-IOR-17012428). Date of Registration: 21 Aug. 2017.