Regional Anesthesia Doesn't Up Falls After Knee Replacement
(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, MD, PhD, 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 (2006–2010) and were treated at more than 400 acute care hospitals.
The researchers found that the incidence of IF was 1.6% overall. Anesthetic techniques included neuraxial (10.9%); combined neuraxial/general (12.9%); and general anesthesia (76.2%). In 12.1% of cases, PNB was used. IFs were seen in patients that were older (average age, 68.9 vs. 66.3 years), had higher comorbidity burden (average Deyo index, 0.77 vs. 0.66), and had more major complications, including higher 30-day mortality (0.8% vs. 0.1%; all P<0.001). The adjusted odds of IF were lower with use of neuraxial anesthesia versus general anesthesia alone (IF incidence, 1.3 vs. 1.6%; odds ratio, 0.70). There was no association between PNB and IF (OR, 0.85; 95% confidence interval, 0.71–1.03).
"Further studies should determine the role of anesthesia practices in the context of fall prevention programs," the authors write.