Regional Anesthesia Doesn't Up Falls After Knee Replacement
Lower adjusted odds of inpatient falls with neuraxial versus general anesthesia
WEDNESDAY, Feb. 26, 2014 (HealthDay News) -- Regional anesthesia, including peripheral nerve block (PNB), does not increase the risk of inpatient falls (IFs) after total knee arthroplasty (TKA), according to a study published in the March issue of Anesthesiology.
Stavros George Memtsoudis, M.D., Ph.D., from the Weill Cornell Medical College of Cornell University in New York City, and colleagues characterized cases of IF and examined associated risk factors for 191,570 TKA patients. Participants were selected from the national Premier Perspective database (2006 to 2010) and were treated at more than 400 acute care hospitals.
The researchers found that the incidence of IF was 1.6 percent overall. Anesthetic techniques included neuraxial (10.9 percent); combined neuraxial/general (12.9 percent); and general anesthesia (76.2 percent). In 12.1 percent of cases, PNB was used. IFs were seen in patients that were older (average age, 68.9 versus 66.3 years), had higher comorbidity burden (average Deyo index, 0.77 versus 0.66), and had more major complications, including higher 30-day mortality (0.8 percent versus 0.1 percent; all P < 0.001). The adjusted odds of IF were lower with use of neuraxial anesthesia versus general anesthesia alone (IF incidence, 1.3 versus 1.6 percent; odds ratio, 0.70). There was no association between PNB and IF (OR, 0.85; 95 percent confidence interval, 0.71 to 1.03).
"Further studies should determine the role of anesthesia practices in the context of fall prevention programs," the authors write.