PDF(Pubmed)
Abstract：
UNASSIGNED: In the face of an ongoing opioid epidemic and an aging population, the utilization of a successful multimodal pain regimen in patients undergoing total knee arthroplasty (TKA) is vital. This study looks to explore the effect of different types of anesthesia in addition to a multimodal pain regimen on post-operative outcomes after undergoing TKA.
UNASSIGNED: From January 2016 to December 2022, 783 charts of patients undergoing an elective TKA were reviewed. Patients undergoing primary, isolated, and unilateral TKA procedures were included. Patients were grouped into three study arms: 1) general anesthesia (GA); 2) general anesthesia with a local anesthetic adductor canal block (GA + ACB); 3) spinal anesthesia with local anesthetic adductor canal block (SA + ACB). Patients who received other anesthesia types or received ACB utilizing liposomal bupivacaine were excluded.
UNASSIGNED: Of the 420 included patients, 63 patients received GA, 148 GA + ACB, and 209 SA + ACB. Patients in the SA + ACB group had a shorter LOS compared to both the GA + ACB and GA groups (p < 0.01. The SA + ACB group had the lowest daily average OME requirement (p < 0.01). Finally, patients in the SA + ACB group had the lowest average total cost of $11,683.91 (p < 0.01).
UNASSIGNED: Spinal anesthesia with adductor canal block is effective in decreasing opioid usage and improving postoperative outcomes after TKA. Surgeons and anesthesiologists should look to utilize this anesthetic option along with a multimodal regimen when deciding how to best manage postoperative pain after TKA procedures.
UNASSIGNED: Level III.
UNASSIGNED: From January 2016 to December 2022, 783 charts of patients undergoing an elective TKA were reviewed. Patients undergoing primary, isolated, and unilateral TKA procedures were included. Patients were grouped into three study arms: 1) general anesthesia (GA); 2) general anesthesia with a local anesthetic adductor canal block (GA + ACB); 3) spinal anesthesia with local anesthetic adductor canal block (SA + ACB). Patients who received other anesthesia types or received ACB utilizing liposomal bupivacaine were excluded.
UNASSIGNED: Of the 420 included patients, 63 patients received GA, 148 GA + ACB, and 209 SA + ACB. Patients in the SA + ACB group had a shorter LOS compared to both the GA + ACB and GA groups (p < 0.01. The SA + ACB group had the lowest daily average OME requirement (p < 0.01). Finally, patients in the SA + ACB group had the lowest average total cost of $11,683.91 (p < 0.01).
UNASSIGNED: Spinal anesthesia with adductor canal block is effective in decreasing opioid usage and improving postoperative outcomes after TKA. Surgeons and anesthesiologists should look to utilize this anesthetic option along with a multimodal regimen when deciding how to best manage postoperative pain after TKA procedures.
UNASSIGNED: Level III.
摘要：
■面对持续的阿片类药物流行和人口老龄化，在接受全膝关节置换术(TKA)的患者中,采用成功的多模式疼痛治疗方案至关重要.本研究旨在探讨不同类型的麻醉以及多模式疼痛方案对TKA术后预后的影响。
■从2016年1月至2022年12月，回顾了783例接受选择性TKA的患者的图表。接受初级治疗的患者，孤立的,包括单侧TKA手术。将患者分为三个研究组：1）全身麻醉（GA）；2）全身麻醉采用局部麻醉收肌管阻滞（GAACB）；3）脊髓麻醉采用局部麻醉收肌管阻滞（SAACB）。接受其他麻醉类型或使用脂质体布比卡因接受ACB的患者被排除在外。
■在纳入的420名患者中，63例患者接受了GA，148GA+ACB,和209SA+ACB。与GA+ACB和GA组相比,SA+ACB组的患者具有更短的LOS(p<0.01。SA+ACB组具有最低的日平均OME需求(p<0.01)。最后,SA+ACB组患者的平均总费用最低,为$11,683.91(p<0.01).
■全麻联合收肌管阻滞可有效减少阿片类药物的使用，改善TKA术后的预后。在决定如何最好地管理TKA手术后的术后疼痛时，外科医生和麻醉师应考虑利用这种麻醉选择以及多模式方案。
■三级。
■从2016年1月至2022年12月，回顾了783例接受选择性TKA的患者的图表。接受初级治疗的患者，孤立的,包括单侧TKA手术。将患者分为三个研究组：1）全身麻醉（GA）；2）全身麻醉采用局部麻醉收肌管阻滞（GAACB）；3）脊髓麻醉采用局部麻醉收肌管阻滞（SAACB）。接受其他麻醉类型或使用脂质体布比卡因接受ACB的患者被排除在外。
■在纳入的420名患者中，63例患者接受了GA，148GA+ACB,和209SA+ACB。与GA+ACB和GA组相比,SA+ACB组的患者具有更短的LOS(p<0.01。SA+ACB组具有最低的日平均OME需求(p<0.01)。最后,SA+ACB组患者的平均总费用最低,为$11,683.91(p<0.01).
■全麻联合收肌管阻滞可有效减少阿片类药物的使用，改善TKA术后的预后。在决定如何最好地管理TKA手术后的术后疼痛时，外科医生和麻醉师应考虑利用这种麻醉选择以及多模式方案。
■三级。
