Evaluating the Association of Anesthesia Type With Postoperative Complications in Patients Undergoing Ankle Fracture Repair

被引:1
作者
Quan, Theodore [1 ,5 ]
Malyavko, Alisa [1 ]
Ifarraguerri, Anna M. [1 ]
Kim, Yumin [1 ]
Mcdaniel, Lea [1 ]
Manzi, Joseph E. [2 ]
Agarwal, Amil R. [1 ]
Chen, Frank R. [3 ]
Gu, Alex [1 ]
Tabaie, Sean [4 ]
机构
[1] George Washington Univ, Sch Med & Hlth Sci, Dept Orthopaed Surg, Washington, DC USA
[2] Weill Cornell Med Coll, New York, NY USA
[3] Hosp Univ Penn, Dept Anesthesiol, Philadelphia, PA USA
[4] Childrens Natl Hlth Syst, Dept Orthopaed Surg, Washington, DC USA
[5] George Washington Hosp, Dept Orthoped Surg, 2300 M St, Washington, DC 20037 USA
关键词
ankle fracture; complications; general anesthesia; neuraxial anesthesia; open reduction; internal fixation; REVISION TOTAL HIP; LENGTH-OF-STAY; OBSTRUCTIVE PULMONARY-DISEASE; GENERAL-ANESTHESIA; INTERNAL-FIXATION; OPEN REDUCTION; SURGERY; EPIDEMIOLOGY; ARTHROPLASTY; MANAGEMENT;
D O I
10.1053/j.jfas.2022.01.025
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
General and neuraxial anesthesia are both successful anesthesia techniques used in many orthopedic procedures. The purpose of this study was to compare the complications and length of hospital stay between patients who underwent general anesthesia versus neuraxial anesthesia during the repair of ankle fractures. Patients undergo-ing open reduction and internal fixation for ankle fracture from 2014 to 2018 were identified in the National Surgi-cal Quality Improvement Program database. Patients were stratified into 2 cohorts: general anesthesia and neuraxial anesthesia. In this analysis, demographics data, comorbidities, and postoperative complications were collected and compared between the two cohorts. Bivariate analyses and multivariable logistical regression were performed. Of 3585 patients who underwent operative treatment for ankle fracture, 3315 patients (92.5%) had general anesthesia and 270 (7.5%) had neuraxial anesthesia. On bivariate analyses, patients who had neuraxial anesthesia were more likely to develop pulmonary complications (p = .173) or extended length of stay more than 5 days (p = .342) compared to the general anesthesia group. Following adjustment on multivariate analyses, the neuraxial anesthesia cohort no longer had increased likelihood of pulmonary complications or extended length of stay compared to the general anesthesia group. Healthy ankle fracture patients could also benefit from neuraxial anesthetic methods, and they should be considered for this anesthetic type regardless of their lack of comorbid-ities.(c) 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.
引用
收藏
页码:1086 / 1090
页数:5
相关论文
共 28 条
[1]   Comparison of Regional Anesthesia Timing on Pain, Opioid Use, and Postanesthesia Care Unit Length of Stay in Patients Undergoing Open Reduction and Internal Fixation of Ankle Fractures [J].
Alexander, John C. ;
Sunna, Mary ;
Minhajuddin, Abu ;
Liu, George ;
Sanders, Drew ;
Starr, Adam ;
Gasanova, Irina ;
Joshi, Girish P. .
JOURNAL OF FOOT & ANKLE SURGERY, 2020, 59 (04) :788-791
[2]   Association of race and ethnicity in the receipt of regional anesthesia following mastectomy [J].
Beletsky, Alexander ;
Burton, Brittany Nicole ;
Finneran, John J. ;
Alexander, Brenton S. ;
Macias, Alvaro ;
Gabriel, Rodney Allanigue .
REGIONAL ANESTHESIA AND PAIN MEDICINE, 2021, 46 (02) :118-123
[3]   Impact of Operative Time on Adverse Events Following Primary Total Joint Arthroplasty [J].
Bohl, Daniel D. ;
Ondeck, Nathaniel T. ;
Darrith, Brian ;
Hannon, Charles P. ;
Fillingham, Yale A. ;
Della Valle, Craig J. .
JOURNAL OF ARTHROPLASTY, 2018, 33 (07) :2256-+
[4]   Aseptic revision total hip arthroplasty in the elderly QUANTIFYING THE RISKS FOR PATIENTS OVER 80 YEARS OLD [J].
Bovonratwet, P. ;
Malpani, R. ;
Ottesen, T. D. ;
Tyagi, V. ;
Ondeck, N. T. ;
Rubin, L. E. ;
Grauer, J. N. .
BONE & JOINT JOURNAL, 2018, 100B (02) :143-151
[5]   Anesthesia Type Is Not Associated With Postoperative Complications in the Care of Patients With Lower Extremity Traumatic Fractures [J].
Brovman, Ethan Y. ;
Wallace, Frances C. ;
Weaver, Michael J. ;
Beutler, Sasha S. ;
Urman, Richard D. .
ANESTHESIA AND ANALGESIA, 2019, 129 (04) :1034-1042
[6]  
Capdevila X, 2004, Acta Anaesthesiol Belg, V55 Suppl, P33
[7]   EPIDEMIOLOGY OF ANKLE FRACTURES IN ROCHESTER, MINNESOTA [J].
DALY, PJ ;
FITZGERALD, RH ;
MELTON, LJ ;
ILSTRUP, DM .
ACTA ORTHOPAEDICA SCANDINAVICA, 1987, 58 (05) :539-544
[8]   Spinal versus general anesthesia for orthopedic surgery: Anesthesia drug and supply costs [J].
Gonano, C ;
Leitgeb, U ;
Sitzwohl, C ;
Ihra, G ;
Weinstabl, C ;
Kettner, SC .
ANESTHESIA AND ANALGESIA, 2006, 102 (02) :524-529
[9]   Longer Operative Time Is Independently Associated With Surgical Site Infection and Wound Dehiscence Following Open Reduction and Internal Fixation of the Ankle [J].
Gowd, Anirudh K. ;
Bohl, Daniel D. ;
Hamid, Kamran S. ;
Lee, Simon ;
Holmes, George B. ;
Lin, Johnny .
FOOT & ANKLE SPECIALIST, 2020, 13 (02) :104-111
[10]   Regional Versus General Anesthesia in Surgical Patients with Chronic Obstructive Pulmonary Disease: Does Avoiding General Anesthesia Reduce the Risk of Postoperative Complications? [J].
Hausman, Mark S., Jr. ;
Jewell, Elizabeth S. ;
Engoren, Milo .
ANESTHESIA AND ANALGESIA, 2015, 120 (06) :1405-1412