# TRIAL OF EPIDURAL VERSUS GENERAL ANESTHESIA

> **NIH NIH R01** · HOSPITAL FOR SPECIAL SURGERY · 1990 · $97,316

## Abstract

Specific aims:  This randomized trial will assess the impact of
epidural versus general anesthesia on cognitive and cardiac
complications in a predominantly elderly population undergoing
unilateral or bilateral primary total knee replacement.  Secondly,
this trial will document and comprehensively assess the incidence
of persistent post-operative losses in cognitive function in an
elderly population undergoing elective non-cardiac surgery.
Thirdly, this study will test the reproducibility, validity, and
responsiveness of a newly developed evaluative functional scale of
cognitive performance in daily activities in this population.

Experimental design and methods:  A prospective randomized trial
in predominantly elderly patients undergoing elective unilateral
or bilateral total knee replacement assessing the effect of general
versus epidural anesthesia on the outcomes of cardiac and cognitive
complications.  Baseline clinical and demographic data and
comprehensive intra-operative monitoring data will be collected and
analyzed.  Occurrence of persistent deterioration of performance
will be assessed in five cognitive domains of linguistic,
psychomotor, attention, visuopatial, and memory function.  Outcome
will be measured by intrasubject comparison of psychometric test
results three months post-operatively versus pre-operatively.
Occurrence of major cardiac complications will be evaluated using
a sensitive surveillance protocol to detect peri-operative
myocardial infarction, pulmonary edema, pulmonary emboli and
congestive heart failure.  The administrator of the cognitive
tests, the co-investigators assessing and reviewing post-operative
cardiac outcomes, and the co-investigators reviewing and analyzing
the cognitive test results will be blinded to the type of
anesthesia intervention.  Functional impact will be assessed with
an evaluative scale administered pre-operatively and three months
pre-operatively and three months post-operatively to both the
patient and a close observer of the patient.  The results of the
functional scale will be correlated with the results of serial
interpreted.

Long term objectives:  The long term objective is to prevent
functionally significant post-operative cognitive complications,
without a simultaneous increase in cardiac complications, in
elderly patients undergoing elective surgery.

## Key facts

- **NIH application ID:** 3120273
- **Project number:** 5R01AG008562-02
- **Recipient organization:** HOSPITAL FOR SPECIAL SURGERY
- **Principal Investigator:** Pamela G Russo
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 1990
- **Award amount:** $97,316
- **Award type:** 5
- **Project period:** 1989-07-01 → 1992-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/3120273

## Citation

> US National Institutes of Health, RePORTER application 3120273, TRIAL OF EPIDURAL VERSUS GENERAL ANESTHESIA (5R01AG008562-02). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/3120273. Licensed CC0.

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