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Spinal anestesi vs. allmän anestesi för THA, TKA och UKA (RCT SAGA)

17 september 2026 uppdaterad av: Anders Troelsen

Randomiserad prövning av spinalbedövning vs. allmän anestesi (SAGA) om återhämtning efter total höft-, knä- och enkompartmentell knäprotesplastik

The goal of this randomized clinical trial is to investigate the postoperative recovery following hip and knee arthroplasty procedures depending on the use of either spinal anaesthesia (SA) or general anaesthesia (GA).

The main questions are:

  • Are more patients able to be safely mobilized within 6 hours postoperatively when using GA compared to SA?
  • Does postoperative pain, nausea and vomiting, dizzyness, occurence of delirium and urinary retention differ between the anaesthetic methods?

Participants, scheduled for total hip, total knee and unicomartmental knee arthroplasty, will be randomized to recieve spinal anaesthesia or general anaesthesia in relation to surgery. At 6 hours postoperatively a physiotherapist will conduct a 5-meter walking test to evaluate whether the participant can be safely mobilized.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Faktisk)

222

Fas

  • Fas 4

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Danmark
      • Hvidovre, Danmark, 2650
        • Christian Bredgaard Jensen
      • Vejle, Danmark, 7100
        • Vejle Hospital

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • Clinical and radiological hip or knee osteoarthritis meeting the indications for primary total hip, total knee, or unicompartmental knee arthroplasty.
  • ≥18 years of age.
  • Able to speak and understand Danish
  • Able to give informed consent and must be cognitively intact.

Exclusion Criteria:

  • Lives in an institution.
  • Uses walking aid such as a walker or a wheelchair.
  • Terminal illness.
  • Has contraindications for either general or spinal anaesthesia.
  • Has objections to receiving either general or spinal anaesthesia.
  • Requires anxiolytics as premedication prior to anaesthesia.
  • Traumatic aetiology as a basis for surgical indication.
  • Altered pain perception and / or neurologic affection due to diabetes or other disorders.
  • Daily preoperative use of opioids > 30 mg of morphine milligram equivalents (MME).
  • Standard primary arthroplasty procedure is evaluated not to be suitable.
  • Women considered fertile but without sufficient birth control.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Spinal Anaesthesia (SA)

Patients undergoing total hip, total knee or unicompartmental knee arthroplasty are anaesthetized using:

Plain or heavy Bupivacaine hydrochloride 10 mg (2 mL)
Läkemedel: Spinal anesthesia

plain or heavy Bupivacaine hydrochloride 10 mg (2 mL) injected in the spinal canal

Andra namn:
  • Spinalbedövning
Experimentell: General Anaesthesia (GA)

Patients undergoing total hip, total knee or unicompartmental knee arthroplasty are anaesthetized using:

Propofol (induction: 1.0-2.0 mg/kg. infusion: 3-5 mg/kg/hour) + Remifentanil (induction: 3-5 mcg/kg, infusion: 0.5 mcg/kg/min)
Läkemedel: General anaesthesia

Propofol (induction: 1.0-2.0 mg/kg. infusion: 3-5 mg/kg/hour) + Remifentanil (induction: 3-5 mcg/kg, infusion: 0.5 mcg/kg/min) given intravenously

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Ability to be mobilsed safely within 6 hours of surgery
Tidsram: within 6 hours postoperatively.

5-meter walking test where a physiotherapist evaluates whether the participant can be safely mobilized within 6 hours of surgery.
within 6 hours postoperatively.

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Fulfilment of discharge criteria
Tidsram: On the day of surgery: at 4 hours postoperatively and 6 hours postoperatively. From postoperative day 1 and until discharge (on average 1 day): at 10.00 and at 18.00. This will be asses as long as the patient is admitted.

Dichotomous (Yes or No)
On the day of surgery: at 4 hours postoperatively and 6 hours postoperatively. From postoperative day 1 and until discharge (on average 1 day): at 10.00 and at 18.00. This will be asses as long as the patient is admitted.
Pain score
Tidsram: On the day of surgery: at 4 hours postoperatively and 6 hours postoperatively. From postoperative day 1 and until discharge (on average 1 day): at 10.00 and at 18.00. This will be asses as long as the patient is admitted.

Will be recorded during rest and 5-m walk using participant evaluated NRS of 0 to 10, with 10 being worst pain/dizziness/nausea imaginable. This will be recorded at 4 and 6 hours post-operatively on the day of surgery and at 10:00 and 18:00 on the following postoperative days.
On the day of surgery: at 4 hours postoperatively and 6 hours postoperatively. From postoperative day 1 and until discharge (on average 1 day): at 10.00 and at 18.00. This will be asses as long as the patient is admitted.
Opioid use in Morphine Milligram Equivilents within the first 6 hours of surgery
Tidsram: On the day of surgery: Within the first 6 hours after surgery.

Cumulated opioid use in Morphine Milligram Equivalents.
On the day of surgery: Within the first 6 hours after surgery.
Nausea Score
Tidsram: On the day of surgery: at 4 hours postoperatively and 6 hours postoperatively. From postoperative day 1 and until discharge (on average 1 day): at 10.00 and at 18.00. This will be asses as long as the patient is admitted.

Will be recorded during rest and 5-m walk using participant evaluated NRS of 0 to 10, with 10 being worst pain/dizziness/nausea imaginable. This will be recorded at 4 and 6 hours post-operatively on the day of surgery and at 10:00 and 18:00 on the following postoperative days.
On the day of surgery: at 4 hours postoperatively and 6 hours postoperatively. From postoperative day 1 and until discharge (on average 1 day): at 10.00 and at 18.00. This will be asses as long as the patient is admitted.

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Vital signs - systolic blood pressure
Tidsram: On the day of surgery: at 4 hours postoperatively and 6 hours postoperatively. From postoperative day 1 and until discharge (on average 1 day): at 10.00 and at 18.00. This will be asses as long as the patient is admitted.

Systolic blood pressure (mmHg).
On the day of surgery: at 4 hours postoperatively and 6 hours postoperatively. From postoperative day 1 and until discharge (on average 1 day): at 10.00 and at 18.00. This will be asses as long as the patient is admitted.
Vital signs - diastolic blood pressure
Tidsram: On the day of surgery: at 4 hours postoperatively and 6 hours postoperatively. From postoperative day 1 and until discharge (on average 1 day): at 10.00 and at 18.00. This will be asses as long as the patient is admitted.

Diastolic blood pressure (mmHg).
On the day of surgery: at 4 hours postoperatively and 6 hours postoperatively. From postoperative day 1 and until discharge (on average 1 day): at 10.00 and at 18.00. This will be asses as long as the patient is admitted.
Quality of Recovery-15 score
Tidsram: On the day of surgery: at 4 hours postoperatively. From postoperative day 1 and until discharge (on average 1 day): at 10.00. This will be asses as long as the patient is admitted.

Four hours postoperatively on the day of surgery and at 10:00 on the following
On the day of surgery: at 4 hours postoperatively. From postoperative day 1 and until discharge (on average 1 day): at 10.00. This will be asses as long as the patient is admitted.

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Anders Troelsen

Samarbetspartners

Vejle Hospital

Utredare

  • Huvudutredare: Anders Troelsen, MD, DMSc, Hvidovre University Hospital

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

6 mars 2023

Primärt slutförande (Faktisk)

6 april 2025

Avslutad studie (Faktisk)

6 april 2025

Studieregistreringsdatum

Först inskickad

11 januari 2023

Först inskickad som uppfyllde QC-kriterierna

30 januari 2023

Första postat (Faktisk)

31 januari 2023

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

18 september 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

17 september 2026

Senast verifierad

1 september 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 2022-501221-21-00

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