局部麻醉
外围设备
神经轴阻滞
神经刺激器
麻醉学
局部麻醉剂
外科
静脉局部麻醉
作者
Crispiana Cozowicz,Jashvant Poeran,Nicole Zubizarreta,Madhu Mazumdar,Stavros G. Memtsoudis
出处
期刊:Regional Anesthesia and Pain Medicine
[BMJ]
日期:2016-01-01
卷期号:41 (1): 43-49
被引量:48
标识
DOI:10.1097/aap.0000000000000342
摘要
Background A growing body of evidence indicates that the use of regional anesthesia offers advantages over general anesthesia, not only in terms of reducing complications but also regarding resource utilization and patient satisfaction. Because of the paucity of data on the nationwide adoption of regional anesthesia techniques, we aimed to elucidate trends in the use of neuraxial anesthesia (NA) and peripheral nerve blocks (PNBs) in orthopedic surgeries. Methods We extracted data from N = 959,257 (Premier Perspective database; 2006–2013) total hip and knee arthroplasties (THA, TKA) and assessed NA/PNB use by a 2-year period, stratified by demographics and hospital factors. Cochran-Armitage trend tests assessed significance of trends. Results Comparing 2006–2007 with 2012–2013, NA utilization decreased slightly from 21.7% to 19.7% for THA patients; this was 24.7% to 21.3% for TKA patients (with the main drop between 2012 and 2013). Conversely, PNB utilization increased from 6.5% to 8.7% for THA patients and 10.3% to 20.4% for TKA patients (all P Conclusions Our findings provide important insight into the dynamics of the adoption of regional anesthetic techniques. Whereas PNB utilization is significantly increasing, overall, NA and PNBs are performed in the minority of cases. With accumulating evidence in favor of regional anesthesia, promoting the use of NA and a further increase in PNB utilization could have far-reaching medical and economic implications.
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