PNBs Associated With Improved Outcomes in Hip, Knee Arthroplasty

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New research suggests that PNBs are linked to better medical and economic outcomes in patients receiving hip and knee replacement.
New research suggests that PNBs are linked to better medical and economic outcomes in patients receiving hip and knee replacement.

New research suggests that peripheral nerve blocks (PNBs) are linked to better medical and economic outcomes in patients receiving hip and knee replacement.

Using data from the national Premier Perspective database, researchers examined more than 1 million cases of hip and knee arthroplasty over a 7-year period, comparing the rate of complications, including heart attack; lung, gastrointestinal, and kidney complications; stroke; infection; wounds; clots; inpatient falls; and mortality, between those receiving a PNB to those without the intervention.

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The investigators concluded that 17.9% of the patients received a PNB, with an increase among knee arthroplasty patients, going from 15.2% in 2006 to 24.5% in 2013. There was a significant association between the use of PNB and lower odds for nearly all complications. When comparing those with PNBs versus those without, the researchers found the strongest associations in patients with wound complications and hip arthroplasty (OR 0.45 [95% CI 0.44-0.66]), and in patients with cardiac complications and knee arthroplasty (OR 0.72 [95% CI, 0.67-0.76]).

"The use of PNB was significantly associated with lower odds for numerous complications and improved resource utilization parameters," the authors wrote. "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 research will be presented at the 41st Annual Regional Anesthesiology and Acute Pain Medicine Meeting held March 31-April 2, 2016 in New Orleans, Louisiana.

Reference

Memtsoudis S, Poeran J, Cozowicz C, Zubizarreta N, Ozbek U, Mazumdar M, et al. Abstract #1623. The impact of peripheral nerve blocks on perioperative outcome in hip and knee arthroplasty - a population based study. Presented at: ASRA 2016. March 31-April 2, 2016; New Orleans, Louisiana.

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