Clinical Comparison of Spinal Anaesthesia and General Anaesthesia for Total Knee Arthroplasty

Background: Total knee arthroplasty is a commonly performed surgical procedure for the management of advanced degenerative knee diseases such as osteoarthritis and rheumatoid arthritis. The choice of anaesthetic technique influences perioperative outcomes, postoperative pain control, complications, and recovery. Spinal anaesthesia and general anaesthesia are the two most frequently used techniques for this procedure. Aim: To compare the clinical outcomes of spinal anaesthesia and general anaesthesia in patients undergoing total knee arthroplasty. Materials and Methods: This comparative observational study was conducted in the Department of Anaesthesia at a tertiary-care teaching hospital affiliated with Meenakshi Medical College Hospital & Research Institute, Kanchipuram. A total of 80 patients undergoing total knee arthroplasty were included and divided into two groups. Group A consisted of 40 patients who received spinal anaesthesia, while Group B included 40 patients who underwent surgery under general anaesthesia. Demographic characteristics, intraoperative hemodynamic parameters, estimated blood loss, postoperative pain scores, complications, and recovery outcomes were recorded and analyzed. A p value less than 0.05 was considered statistically significant. Results: Demographic characteristics were comparable between the two groups. Patients receiving spinal anaesthesia demonstrated better intraoperative hemodynamic stability (p < 0.05) and significantly lower blood loss (320 ± 85 ml vs 410 ± 96 ml; p = 0.001). Postoperative pain scores at 6 and 24 hours were significantly lower in the spinal anaesthesia group (p = 0.001). Earlier mobilization and shorter hospital stay were also observed. Conclusion: Spinal anaesthesia provides improved hemodynamic stability, reduced blood loss, better postoperative analgesia, and faster recovery compared with general anaesthesia in total knee arthroplasty.