Effects of Peripheral Nerve Blocks on THA, TKA Outcomes

The perioperative use of peripheral nerve blocks (PNBs) was associated with lower risk of complications in patients undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA), according to data presented at the 2016 annual Regional Anesthesiology and Acute Pain Medicine Meeting.

Using data from the national Premier Perspective database, researchers examined more than 1 million THA and TKA surgical cases over a 7-year period, comparing the rate of complications, including myocardial infarction; lung, gastrointestinal, and kidney complications; stroke; infection; wounds; clots; inpatient falls; and mortality, between patients who received a PNB when compared to those who did not.

Researchers found a significant association between the use of PNB and a lower odds ratio (OR) for nearly all postoperative complications analyzed. 

“The strongest effects were seen for wound complications (odds ratio 0.54; 95% CI 0.44-0.66) in THA patients and for cardiac complications (OR 0.72 [95% CI, 0.67-0.76]) in TKA patients, when comparing those with PNBs versus those without”, the authors stated.

The use of PNB was also associated with improved healthcare resource utilization parameters as defined by the cost of hospitalization, length of hospital stay, morphine equivalent opioid consumption, admission to an intensive care unit, and the need for postoperative blood transfusions.

Summary and Clinical Applicability

Peripheral nerve blocks improved outcomes and resource utilizations in patients undergoing primary THA or TKA in this study population.

 “Considering the relatively low utilization of PNBs, these results suggest that a wider implementation of regional anesthetic techniques may potentially lead to a large impact on medical and economic perioperative outcomes,” the authors wrote. 

This research was accepted for abstract presentation at the 41st Annual Regional Anesthesiology and Acute Pain Medicine Meeting, on March 31-April 2, 2016 in New Orleans, Louisiana. These results have yet to undergo the peer review process prior to full-length journal publication. 

Reference

Memtsoudis S, Poeran J, Cozowicz C, et al. The impact of peripheral nerve blocks on perioperative outcome in hip and knee arthroplasty – a population based study. Abstract #1623. Presented at the 41st Annual Regional Anesthesiology and Acute Pain Medicine Meeting; American Society for Regional Anesthesia; March 31-April 2, 2016; New Orleans, Louisiana.

This article originally appeared on Clinical Pain Advisor