Short answerProbably a little. A large review found fewer complications with spinal or epidural anaesthesia than with general anaesthesia. Most of the evidence is from observational studies.
Probably helps a little
What it is
Hip and knee replacements can be done with general anaesthesia, where you are asleep, or with neuraxial anaesthesia, which means a spinal or epidural injection that numbs the lower body. The anaesthetist and the patient choose between them.
What the research shows
reviewed 94 studies that compared neuraxial with general anaesthesia in hip and knee replacement. Neuraxial anaesthesia was linked to lower odds, or no difference, in nearly all the complications they measured. The exception was urinary retention, where it was higher with neuraxial anaesthesia.
After hip replacement, the odds of death were lower with neuraxial anaesthesia, with an odds ratio of 0.67, and so were lung complications and blood transfusion. After knee replacement, the odds of death were not clearly different, with an odds ratio of 0.83 and a range that included no difference. Transfusion was lower.
The group recommended neuraxial anaesthesia for hip replacement and preferred it for knee replacement. They rated the evidence as low to moderate. They described the recommendation for knees as weak.
Most of the studies were not randomised, so people who had one type may have differed from people who had the other.
Risks and effort
Neuraxial anaesthesia was linked to more urinary retention in the review. It cannot be used in everyone, and your anaesthetist will check if it suits you.
What usually works instead
Both types are used widely and safely. Your anaesthetist will discuss the options with you before surgery. See Total Knee Replacement and What is a Total Hip Replacement?.
Questions people ask
Will I be awake with a spinal?
Ask your anaesthetist what is offered with a spinal.
Is general anaesthesia unsafe?
No. These results describe averages across many people.
Can I choose?
Yes. Discuss your preference and your health with your anaesthetist.
Sources
Select a source to read what the study or guideline found, in plain words, with a link to the original.
Last reviewed 24 October 2026. Next review due October 2027.
