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Peripheral nerve block use reduced odds for complications after THA, TKA

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Results of a retrospective study demonstrated peripheral nerve block use correlated with lower odds for complications and a reduction in use of resources for hip and knee arthroplasty.

“The joint replacement population included an elderly group of patients with co-existing medical conditional that put them at risk for complications, and it is important to find ways to minimize the risk,” Stavros G. Memtsoudis, MD, PhD, a researcher for the study, said in a press release from Hospital for Special Surgery. “In addition, the volume of joint replacements is projected to grow dramatically in the future. Considering the relatively infrequent use of [peripheral nerve blocks] PNBs, our study results suggest that a wider implementation of regional anesthetic techniques could potentially have a major positive impact on both medical and economic outcomes.”

Memtsoudis and colleagues conducted a retrospective study using the National Premier Perspective database and identified 1,062,152 patients who underwent either total hip arthroplasty (THA) or total knee arthroplasty (TKA). Investigators used multilevel multivariable logistic regression models to determine the correlation between outcomes and use of PNBs.

Complications and implant failure were the main outcome measures. Resources used by patients included blood transfusions, ICU admission, opioid consumption, length of stay and hospital costs.

Memtsoudis noted 17.9% of patients needed a PNB, with an increase from 2006 to 2013 with rates of 15.2% to 24.5% for those years, respectively, in patients who underwent TKA. PNB use significantly correlated with lower chances for all complications. Investigators noted the strongest correlation with PNBs in THA patients was seen for wound complications and between PNBs and cardiac complications for TKA patients. ‒ by Monica Jaramillo

References:

Memtsoudis SG, et al. The impact of peripheral nerve blocks on perioperative outcome in hip and knee arthroplasty — A population based study. Presented at: Annual Regional Anesthesiology and Acute Paid Medicine Meeting; March 31-April 2, 2016; New Orleans.

www.hss.edu