Frank R Chen1, Theodore Quan2, Joseph E Manzi3, Alex Gu4, Chapman Wei2, Sean Tabaie5, Marc Chodos4, Cary B Chapman6, Kane O Pryor7, Jiabin Liu7,8. 1. Department of Anesthesiology, Hospital of the University of Pennsylvania, Philadelphia, Pennysylvania, USA. 2. George Washington University School of Medicine and Health Sciences, Washington, DC, USA. 3. Weill Cornell Medicine, New York, New York, USA. 4. Department of Orthopaedic Surgery, The George Washington School of Medicine and Health Sciences, Washington, DC, USA. 5. Department of Orthopaedic Surgery, Children's National Health System, Washington, DC, USA. 6. Miami Orthopedics & Sports Medicine Institute, Coral Gables, Florida, USA. 7. Department of Anesthesiology, New York-Presbyterian Hospital/ Weill Cornell Medical Center, New York, New York, USA. 8. Department of Regional Anesthesia and Acute Pain Management, Hospital for Special Surgery, New York, New York, USA.
Abstract
Background: Total ankle arthroplasty (TAA) is performed for ankle arthritis and there has been interest investigating which anesthetic method is the best choice in order to optimize perioperative outcomes. In this study, we compared postoperative complications after TAA for patients receiving either 1) general anesthesia alone or 2) general anesthesia plus regional anesthesia. Methods: Patients undergoing primary TAA from 2007 to 2018 were identified in a national database. Patients were stratified into 2 cohorts: general anesthesia and general anesthesia combined with regional anesthesia. In this analysis, 30-day wound, cardiac, pulmonary, renal, thromboembolic, and sepsis complications, as well mortality, postoperative transfusion, urinary tract infection, extended length of stay, and reoperation were assessed. Bivariate analyses and multivariable logistical regression were performed. Results: Of 1,084 total patients undergoing TAA, 878 patients (81.0%) had general anesthesia and 206 (19.0%) had general anesthesia combined with regional anesthesia. Following adjustment, there were no increased risk of postoperative complications in the combined general and regional anesthesia group compared to those who only underwent general anesthesia. Conclusion: Compared to general anesthesia alone, the addition of regional anesthesia to general anesthesia for TAA is not associated with increased risk of complications in the perioperative period. Level of Evidence: III.
Background: Total ankle arthroplasty (TAA) is performed for ankle arthritis and there has been interest investigating which anesthetic method is the best choice in order to optimize perioperative outcomes. In this study, we compared postoperative complications after TAA for patients receiving either 1) general anesthesia alone or 2) general anesthesia plus regional anesthesia. Methods: Patients undergoing primary TAA from 2007 to 2018 were identified in a national database. Patients were stratified into 2 cohorts: general anesthesia and general anesthesia combined with regional anesthesia. In this analysis, 30-day wound, cardiac, pulmonary, renal, thromboembolic, and sepsis complications, as well mortality, postoperative transfusion, urinary tract infection, extended length of stay, and reoperation were assessed. Bivariate analyses and multivariable logistical regression were performed. Results: Of 1,084 total patients undergoing TAA, 878 patients (81.0%) had general anesthesia and 206 (19.0%) had general anesthesia combined with regional anesthesia. Following adjustment, there were no increased risk of postoperative complications in the combined general and regional anesthesia group compared to those who only underwent general anesthesia. Conclusion: Compared to general anesthesia alone, the addition of regional anesthesia to general anesthesia for TAA is not associated with increased risk of complications in the perioperative period. Level of Evidence: III.
Authors: Daniel D Bohl; Nathaniel T Ondeck; Brian Darrith; Charles P Hannon; Yale A Fillingham; Craig J Della Valle Journal: J Arthroplasty Date: 2018-02-17 Impact factor: 4.757
Authors: Aaron Z Chen; Alex Gu; Nicolas A Selemon; Jordan S Cohen; Chapman Wei; Haley Tornberg; Marc D Chodos; Joshua Campbell; Peter K Sculco Journal: Eur J Orthop Surg Traumatol Date: 2020-08-08