{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T16:24:02Z","timestamp":1789143842294,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100009228","name":"Region \u00d6rebro l\u00e4n","doi-asserted-by":"publisher","award":["OLL\u20101010516"],"award-info":[{"award-number":["OLL\u20101010516"]}],"id":[{"id":"10.13039\/501100009228","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009228","name":"Region \u00d6rebro l\u00e4n","doi-asserted-by":"publisher","award":["OLL\u2010993657"],"award-info":[{"award-number":["OLL\u2010993657"]}],"id":[{"id":"10.13039\/501100009228","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Same\u2010day discharge after primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) is increasing, but the optimal anaesthetic technique for outpatient pathways remains uncertain. Neuraxial anaesthesia is widely recommended based on observational evidence, whereas fast\u2010track programmes using short\u2010acting total intravenous anaesthesia may facilitate early mobilisation and discharge. No randomised controlled trial has compared general anaesthesia (GA) with spinal anaesthesia (SA) specifically in outpatient primary THA\/TKA using a same\u2010day discharge target.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Analysis<\/jats:title>\n                    <jats:p>GASPS is a pragmatic, multicentre, parallel\u2010group superiority randomised controlled trial. Adults scheduled for outpatient primary THA or TKA will be randomised 1:1 to GA or SA, with stratification by site and procedure (THA\/TKA). The primary outcome is successful same\u2010day discharge (discharge on the day of surgery) without readmission within 48\u2009h after discharge. The five key secondary outcomes are time to fulfilment of hospital discharge indicators, quality\u2010of\u2010recovery (QoR\u201015) trajectories over postoperative Days 1\u201335, patients' qualitative experiences of anaesthesia and recovery, cost per quality\u2010adjusted life\u2010year and safety (adverse events); all remaining outcomes\u2014including pain, postoperative nausea and vomiting, opioid consumption, mobilisation and patient\u2010reported outcomes (EQ\u20105D\u20105L and HOOS\/KOOS)\u2014are exploratory. An embedded qualitative study will explore patient experiences using semi\u2010structured interviews, and an economic evaluation will compare costs and outcomes from healthcare and societal perspectives. Analyses will follow the intention\u2010to\u2010treat principle; a group sequential design with O'Brien\u2010Fleming boundaries is planned for an interim analysis. Approval has been obtained from the Swedish Medical Products Agency. Written informed consent will be obtained from all participants. Results will be disseminated through peer\u2010reviewed publications, conference presentations and reporting in the EU Clinical Trials Information System (CTIS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study is designed to determine the most effective anaesthetic method for same\u2010day discharge after primary TKA and THA. With increasing outpatient surgeries, this study will be helpful for optimisation of outpatient processes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      EU CT\/CTIS: 2024\u2010520127\u201089\u201000.\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      : NCT07334132\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.70283","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T23:24:45Z","timestamp":1781565885000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["General Anaesthesia Versus Spinal Anaesthesia for Outpatient Total Hip and Knee Arthroplasty: A Randomised Trial Protocol"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1740-7091","authenticated-orcid":false,"given":"Erik","family":"Noppa","sequence":"first","affiliation":[{"name":"School of Medical Sciences, \u00d6rebro University  \u00d6rebro Sweden"},{"name":"Department of Anaesthesiology and Intensive Care, Faculty of Medicine and Health \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4170-6451","authenticated-orcid":false,"given":"Karuna","family":"Dahlberg","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Faculty of Medicine and Health, \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"de Leon","sequence":"additional","affiliation":[{"name":"School of Medical Sciences, \u00d6rebro University  \u00d6rebro Sweden"},{"name":"Department of Anaesthesiology and Intensive 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