Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Koutp, A; Hauer, G; Leitner, L; Kaltenegger, L; Fischerauer, S; Clar, C; Reinbacher, P; Schittek, G; Leithner, A; Sadoghi, P.
Less Induction Time and Postoperative Pain Using Spinal Anesthesia Versus General Anesthesia With or Without the Use of Peripheral Nerve Blocks in Total Knee Arthroplasty.
J Arthroplasty. 2024; 39(4):904-909
Doi: 10.1016/j.arth.2023.10.018
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
- Hauer Georg
- Koutp Amir
- Co-Autor*innen der Med Uni Graz
- Fischerauer Stefan Franz
- Leithner Andreas
- Leitner Lukas
- Reinbacher Patrick
- Sadoghi Patrick
- Schittek Gregor Alexander
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- Abstract:
- BACKGROUND: Our aim was to analyze anesthetic induction time and postoperative pain using spinal anesthesia versus general anesthesia with or without the use of peripheral nerve blocks (PNBs) in total knee arthroplasty. The hypothesis was that spinal anesthesia would be beneficial with respect to induction time and postoperative pain and that PNBs would complement this effect. METHODS: Patients were stratified according to demographics, American Society of Anesthesiologists physical status classification system (ASA), and opioid intake and divided into: (A) general anesthesia without PNB; (B) general anesthesia with PNB; (C) spinal anesthesia without PNB; and (D) spinal anesthesia with PNB. Endpoints were anesthetic induction time, opioid consumption, and pain. Of 559 patients, 348 (62.3%) received general anesthesia (consisting of group A with 46 and group B with 302 patients), and 211 (37.7%) spinal anesthesia (consisting of group C with 117 and group D with 94 patients). RESULTS: We observed significantly lower total opioid intake 48 hours postoperative when applying spinal anesthesia by 2.08 mg (P < .05) of intravenous morphine-equivalent, and a reduction of 7.0 minutes (P < .05) until skin incision. The application of a PNB achieved a reduction of piritramide intake of 3.59 mg (P < .05) 48 hours postoperative and lengthened induction time by 8.5 minutes (P < .05). CONCLUSIONS: Statistically shorter anesthetic induction times without clinical relevance, but lower postoperative opioid dosages with clinical relevance were observed for patients undergoing total knee arthroplasty with spinal anesthesia. The additional application of PNBs led to a lower need for opioids and lower pain levels in the early postoperative phase.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Anesthesia, Spinal - methods
- Arthroplasty, Replacement, Knee - adverse effects
- Analgesics, Opioid - therapeutic use
- Peripheral Nerves - administration & dosage
- Pain, Postoperative - drug therapy, prevention & control, etiology
- Anesthesia, General - methods
- Anesthetics - therapeutic use
- Find related publications in this database (Keywords)
- TKA
- general anesthesia
- spinal anesthesia
- peripheral nerve block
- induction time
- postoperative pain