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The use of peripheral nerve blocks (PNBs) is associated with better medical and economic outcomes in patients receiving hip and knee replacement, according to research presented at the annual Regional Anesthesiology and Acute Pain Medicine Meeting.
An estimated 1 million people undergo hip or knee replacement each year in the United States. Patients may be kept awake during the procedure using neuraxial anesthesia, which is associated with fewer complications than general anesthesia. The use of PNBs is on the rise, but still is not used routinely in hip and knee arthroplasty. In the study, about 18% of patients had received PNBs.
Researchers looked at more than 1 million cases of hip and knee arthroplasty over seven years. They compared the rate of complications such as heart attack; lung, gastrointestinal, and kidney complications; stroke; infection; wounds; clots; inpatient falls; and mortality in those receiving a PNB to those without the intervention. They also looked at resource use such as the need for blood transfusion, admission to intensive care, opioid consumption, length of stay, and cost of hospitalization.
In terms of complications and resource use, PNBs were tied to better outcomes than when the intervention was not used irrespective of anesthesia type chosen. The researchers concluded that increased use of PNBs in patients receiving knee and hip reconstruction and replacement could have a significantly positive impact on medical and economic outcomes.
The study was titled “The impact of peripheral nerve blocks on perioperative outcome in hip and knee arthroplasty – a population-based study.” The abstract (no. 1,623) was selected as a “Best of Meeting” winner. The findings were presented by primary author Stavros G. Memtsoudis, MD, PhD, FCCP, clinical professor of anesthesiology and public health at the Weill Cornell Medical College and senior scientist and attending anesthesiologist at the Hospital for Special Surgery, both in New York City. (For more information, go to bit.ly/1o8MRV7.)
Financial Disclosure: Executive Editor Joy Dickinson, Nurse Planner Kay Ball, Physician Reviewer Steven A. Gunderson, DO, and Consulting Editor Mark Mayo report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study. Stephen W. Earnhart discloses that he is a stockholder and on the board for One Medical Passport.