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Study: Neuraxial anesthesia, PNB do not increase falls after TKA

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Researchers with Hospital for Special Surgery in New York City found that, when compared with general anesthesia, two types of regional anesthesia do not make patients more susceptible to falls in the first days after total knee arthroplasty.

“We found that not only do these types of anesthesia not increase the risk of falls, but also spinal or epidural anesthesia may even decrease the risk compared to general anesthesia. This work suggests that fear of in-hospital falls is not a reason to avoid regional anesthesia for orthopedic surgery,” Stavros G. Memtsoudis, MD, PhD, a professor of anesthesiology and public health and director of critical care services at Hospital for Special Surgery in New York, stated in a press release from the American Society of Anesthesiologists. Memtsoudis and colleagues published their results in Anesthesia.

The researchers used the national Premier Perspective database to identify 191,570 total knee replacement patients. Of these patients, 76.2% had general anesthesia, 12.9% had combined neuraxial and general anesthesia, 12.1% had peripheral nerve block (PNB) and 10.9% had neuraxial anesthesia.

The overall incidence of inpatient falls was1.6% and researchers found patients who fell were older, had a higher Deyo index and had more major complications. According to study results, the odds-adjusted rate of an inpatient fall was 1.6% with use of general anesthesia alone vs. 1.3% with neuraxial anesthesia. However, researchers found PNB was not significantly associated with inpatient falls.

 “In this study using data from a wide range of hospital settings, we found this concern seems unfounded especially because hospitals and physicians performing these procedures use fall-prevention programs and are able to reduce the impact of other factors shown to increase fall risk, such as higher narcotic use,” Memtsoudis stated in the release.

References:

Memtsoudis SG. Anesthesiology. 2014;doi:10.1097/ALN.0000000000000120.

www.asahq.org/

Disclosure: The researchers report no relevant financial disclosures.