November 01, 2012
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Regional anesthesia decreases perioperative transfusions in TKA patients

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Using regional anesthesia during bilateral total knee arthroplasty may reduce the amount of perioperative blood transfusions for patients, according to researchers from Hospital for Special Surgery.

“The use of neuraxial anesthesia may not always be feasible in every patient, but it should be considered more frequently,” Stavros G. Memtsoudis, MD, PhD, from Hospital for Special Surgery in New York, stated in a press release. “You should not be asking doctors who do not use neuraxial anesthesia in their daily practice to suddenly switch over and start doing it, but there is a lot of education that needs to be done in terms of training residents and orthopedic surgeons to point out the impact of the choice of anesthetic technique on outcomes beyond the operating room.”

 

Stavros G. Memtsoudis

Researchers analyzed data from 15,687 procedures performed in nearly 400 national acute care hospitals during 2006 and 2010, according to the abstract. Memtsoudis and colleagues found that when surgeons used neuraxial anesthesia and a combination of neuraxial and general anesthesia than general anesthesia alone, there was a significant reduction in the amount of needed blood transfusions in the patients.

orthomind

Neuraxial and neuraxial-general anesthesia were associated with a 16% and 6% reduction in major complications compared to general anesthesia but only the blood transfusions were statistically significant. In-hospital mortality, 30-day mortality and complication rates were also lower under in patients who received neuraxial anesthesia, but this was also not statistically significant, according to the abstract.

Reference:

Stunder O. Region Anesth Pain M. 2012;doi:10.1097/AAP.0b013e31826e1494.

Disclosure: The authors received funds from the Clinical Translational Science Center at Weill Cornell Medical College, the National Institute of Health’s National Center for Advancing Translational Services and the Agency for Healthcare Research and Quality’s Center for Education, Research and Therapeutics to conduct this study.