Regional vs. General Anesthesia for Total Knee and Hip Replacement: An Analysis of Postoperative Pain Perception from the International PAIN OUT Registry

Pain Practice : the Official Journal of World Institute of Pain
Katharina DonauerAlexander Wolf

Abstract

Total hip and knee replacements are common surgeries, and an optimal pain treatment is essential for early rehabilitation. Since data from randomized controlled trials on the use of regional anesthesia in joint replacements of the lower extremities are conflicting, we analyzed the international PAIN OUT registry for comparison of regional anesthesia vs. general anesthesia regarding pain and morphine consumption on the first postoperative day. International Classification of Diseases-9 (ICD-9) codes were used to identify 2,346 cases of knee arthroplasty and 2,315 cases of hip arthroplasty between 2010 and 2016 from the PAIN OUT registry. Those were grouped according to anesthesia provided (general, regional, and a combination of both). On the first day after surgery, pain levels and opioid consumption were compared. Adjusted odds ratios (ORs [and 95% confidence intervals (CIs)]) were calculated with logistic regression, and propensity matching was used as a sensitivity analysis. After adjustment for confounders, regional anesthesia was associated with reduced opioid consumption (OR 0.20 [95% CI 0.13 to 0.30], P < 0.001) and less pain (OR 0.53 [95% CI 0.36 to 0.78], P = 0.001) than was general anesthesia in knee surgery. In hip s...Continue Reading

Associated Clinical Trials

References

May 30, 2006·Nature Reviews. Drug Discovery·Joseph A Baur, David A Sinclair
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Nov 23, 2012·The Journal of Bone and Joint Surgery. American Volume·Benjamin E SteinJohn H Wilckens
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Citations

Aug 8, 2019·Clinical Orthopaedics and Related Research·Jacob M WilsonGeorge N Guild
May 31, 2019·The Bone & Joint Journal·L L Nowak, E H Schemitsch
Oct 20, 2020·Drugs & Aging·Joachim HansenJacob Steinmetz
Nov 4, 2020·Clinical Neurology and Neurosurgery·Gaetano De BiaseKingsley Abode-Iyamah
Sep 20, 2020·Annals of Vascular Surgery·John PhairIssam Koleilat
May 1, 2021·Journal of Clinical Medicine·Lukas M Müller-Wirtz, Thomas Volk
Aug 5, 2021·Praxis·Hagen BombergUrs Eichenberger
Sep 16, 2018·Journal of Clinical Anesthesia·Brittany N BurtonRodney A Gabriel

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