Reducing the length of hospital stay after total knee arthroplasty: influence of femoral and sciatic nerve block

Objective: the aim of this study is to evaluate the change in length of hospital stay postoperatively for Total Knee Arthroplasty after using femoral and sciatic nerve block. Materials and methods: the medical records of 287 patients were evaluated, taking into account the number of hours of admission, the percentage and the reason for re-hospitalization within 30 days, as well as associated complications. All patients were divided into two groups according or not to whether they were admitted to ICU or not. During the years 2009 and 2010, isolated spinal anesthesia was the method used in the procedure. From 2011 on, femoral and sciatic nerve blocking was introduced. Results: between the years 2009 and 2012, the average length of stay ranged from 74 hours in 2009 to 75.2 hours in 2010. The average length of stay in 2011 was 56.52 hours and 53.72 hours in 2012, all in the group of patients who did not remain in the ICU postoperatively. In the same period, among those in the group that needed ICU admission, the average length of stay was 138.7 hours in 2009, 90.25 hours in 2010, 79.8 hours in 2011, and 52.91 hours in 2012. During 2009 and 2010, the rate of re-hospitalization was 0%, while in 2011 and 2012, were 3.44% and 1%, respectively. Conclusion: according to this study, the use of femoral and sciatic nerve blocking after total knee arthroplasty allowed significant reduction in hospital stay.

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Two types of anaesthesia and length of hospital stay in patients undergoing unilateral total knee arthroplasty (TKA): a secondary analysis based on a single-centre retrospective cohort study in Singapore

BMC Anesthesiology ◽

10.1186/s12871-021-01459-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xuan JI ◽

Weiqi KE

Keyword(s):

Total Knee Arthroplasty ◽

Logistic Regression ◽

Cohort Study ◽

Length Of Stay ◽

Hospital Stay ◽

Knee Arthroplasty ◽

Subgroup Analysis ◽

Length Of Hospital Stay ◽

Total Knee ◽

Type Of Anaesthesia

Abstract Background Evidence regarding the relationship between the type of anaesthesia and length of hospital stay is controversial. Therefore, the objective of this research was to investigate whether the type of anaesthesia was independently related to the length of hospital stay in patients undergoing unilateral total knee arthroplasty (TKA) after adjusting for other covariates. Methods The present study was a cohort study. A total of 2622 participants underwent total knee arthroplasty (TKA) at a hospital in Singapore from 2013 to 1-1 to 2014-6-30. The target independent variable and the dependent variable were two types of anaesthesia and length of hospital stay, respectively. The covariates included age, BMI, hemoglobin (Hb), length of stay (LOS), duration of surgery, sex, ethnicity, American Society of Anesthesiologist (ASA) Status, smoking, obstructive sleep apnea (OSA), diabetes mellitus (DM), DM on insulin, ischemic heart disease (IHD), congestive cardiac failure (CCF), cerebrovascular accident (CVA), creatinine > 2 mg/dl, day of week of operation. Multivariate linear and logistic regression analyses were performed on the variables that might influence the choice of the two types of anaesthesia and the LOS. This association was then tested by subgroup analysis using hierarchical variables. Results The average age of 2366 selected participants was 66.57 ± 8.23 years old, and approximately 24.18% of them were male. The average LOS of all enrolled patients was 5.37 ± 4.87 days, 5.92 ± 6.20 days for patients receiving general anaesthesia (GA) and 5.09 ± 3.98 days for patients receiving regional anaesthesia (RA), P < 0.05. The results of fully adjusted linear regression showed that GA lasted 0.93 days longer than RA (β = 0.93, 95% CI (0.54, 1.32)), P < 0.05. The results of fully adjusted logistic regression showed that LOS > 6 days was 45% higher for GA than for RA (OR = 1.45, 95% CI (1.15, 1.84)), P < 0.05. Through the subgroup analysis, the results were basically stable and reliable. Conclusion Our study showed that GA increased the length of stay during unilateral TKA compared with RA. This finding needs to be validated in future studies.

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Pain management after total knee arthroplasty: femoral catheter vs femoral catheter plus sciatic nerve block

10.26226/morressier.57108e2dd462b80290b4a094 ◽

2016 ◽

Author(s):

Elena Alvarez Zancada

Keyword(s):

Total Knee Arthroplasty ◽

Pain Management ◽

Sciatic Nerve ◽

Nerve Block ◽

Knee Arthroplasty ◽

Sciatic Nerve Block ◽

Femoral Catheter ◽

Total Knee

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A nomogram for predicting the need for sciatic nerve block after total knee arthroplasty

Journal of Anesthesia ◽

10.1007/s00540-016-2223-0 ◽

2016 ◽

Vol 30 (5) ◽

pp. 864-872 ◽

Cited By ~ 2

Author(s):

Rovnat Babazade ◽

Thilak Sreenivasalu ◽

Pankaj Jain ◽

Matthew T. Hutcherson ◽

Amanda J. Naylor ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Sciatic Nerve ◽

Nerve Block ◽

Knee Arthroplasty ◽

Sciatic Nerve Block ◽

Total Knee

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Effect of Peripheral Nerve Block on Length of Stay after Total Knee Arthroplasty

Anesthesiology ◽

10.1097/aln.0000000000001785 ◽

2017 ◽

Vol 127 (4) ◽

pp. 718-719 ◽

Cited By ~ 1

Author(s):

Jung-Won Hwang ◽

Young-Tae Jeon

Keyword(s):

Total Knee Arthroplasty ◽

Length Of Stay ◽

Peripheral Nerve ◽

Nerve Block ◽

Knee Arthroplasty ◽

Peripheral Nerve Block ◽

Total Knee

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Preoperative Hyponatremia Is Associated with Reoperation and Prolonged Length of Hospital Stay following Total Knee Arthroplasty

The Journal of Knee Surgery ◽

10.1055/s-0038-1641156 ◽

2018 ◽

Vol 32 (04) ◽

pp. 344-351 ◽

Cited By ~ 3

Author(s):

Matthew Abola ◽

Joseph Tanenbaum ◽

Thomas Bomberger ◽

Derrick Knapik ◽

Steven Fitzgerald ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Risk Factor ◽

Hospital Stay ◽

Knee Arthroplasty ◽

Length Of Hospital Stay ◽

Adverse Outcomes ◽

Limited Information ◽

Improvement Program ◽

Prolonged Length ◽

Total Knee

AbstractHyponatremia is a risk factor for adverse surgical outcomes, but limited information is available on the prognosis of hyponatremic patients who undergo total knee arthroplasty (TKA). The purpose of this investigation was to compare the incidence of major morbidity (MM), 30-day readmission, 30-day reoperation, and length of hospital stay (LOS) between normonatremic and hypontremic TKA patients.The American College of Surgeons National Surgical Quality Improvement Program database was used to identify all primary TKA procedures. Hyponatremia was defined as <135 mEq/L and normonatremia as 135 to 145 mEq/L; hypernatremic patients (>145 mEq/L) were excluded. Multivariable logistic regression was used to determine the association between hyponatremia and outcomes after adjusting for demographics and comorbidities. An α level of 0.002 was used and calculated using the Bonferroni correction. Our final analysis included 88,103 patients of which 3,763 were hyponatremic and 84,340 were normonatremic preoperatively. In our multivariable models, hyponatremic patients did not have significantly higher odds of experiencing an MM (odds ratio [OR]: 1.05; 99% confidence interval [CI] 0.93–1.19) or readmission (OR: 1.12; 99% CI: 1–1.24). However, patients with hyponatremia did experience significantly greater odds for reoperation (OR: 1.24; 99% CI: 1.05–1.46) and longer hospital stay (OR: 1.15; 99% CI: 1.09–1.21). We found that hyponatremic patients undergoing TKA had increased odds of reoperation and prolonged hospital stay. Preoperative hyponatremia may be a modifiable risk factor for adverse outcomes in patients undergoing TKA, and additional prospective studies are warranted to determine whether preoperative correction of hyponatremia can prevent complications.

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