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Peripheral nerve block anesthesia/analgesia for patients undergoing primary hip and knee arthroplasty: recommendations from the International Consensus on Anesthesia-Related Outcomes after Surgery (ICAROS) group based on a systematic review and meta-analysis of current literature.
Memtsoudis, Stavros G; Cozowicz, Crispiana; Bekeris, Janis; Bekere, Dace; Liu, Jiabin; Soffin, Ellen M; Mariano, Edward R; Johnson, Rebecca L; Go, George; Hargett, Mary J; Lee, Bradley H; Wendel, Pamela; Brouillette, Mark; Kim, Sang Jo; Baaklini, Lila; Wetmore, Douglas S; Hong, Genewoo; Goto, Rie; Jivanelli, Bridget; Athanassoglou, Vassilis; Argyra, Eriphili; Barrington, Michael John; Borgeat, Alain; De Andres, Jose; El-Boghdadly, Kariem; Elkassabany, Nabil M; Gautier, Philippe; Gerner, Peter; Gonzalez Della Valle, Alejandro; Goytizolo, Enrique; Guo, Zhenggang; Hogg, Rosemary; Kehlet, Henrik; Kessler, Paul; Kopp, Sandra; Lavand'homme, Patricia; Macfarlane, Alan; MacLean, Catherine; Mantilla, Carlos; McIsaac, Dan; McLawhorn, Alexander; Neal, Joseph M; Parks, Michael; Parvizi, Javad; Peng, Philip; Pichler, Lukas; Poeran, Jashvant; Poultsides, Lazaros; Schwenk, Eric S; Sites, Brian D.
Afiliación
  • Memtsoudis SG; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA memtsoudiss@hss.edu.
  • Cozowicz C; Department of Anesthesiology, Critical Care and Pain Management, Weill Cornell Medical College, New York, New York, USA.
  • Bekeris J; Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical Private University, Salzburg, Austria.
  • Bekere D; Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical Private University, Salzburg, Austria.
  • Liu J; Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical Private University, Salzburg, Austria.
  • Soffin EM; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.
  • Mariano ER; Department of Anesthesiology, Critical Care and Pain Management, Weill Cornell Medical College, New York, New York, USA.
  • Johnson RL; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.
  • Go G; Department of Anesthesiology, Critical Care and Pain Management, Weill Cornell Medical College, New York, New York, USA.
  • Hargett MJ; Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA.
  • Lee BH; Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.
  • Wendel P; Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Brouillette M; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.
  • Kim SJ; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.
  • Baaklini L; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.
  • Wetmore DS; Department of Anesthesiology, Critical Care and Pain Management, Weill Cornell Medical College, New York, New York, USA.
  • Hong G; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.
  • Goto R; Department of Anesthesiology, Critical Care and Pain Management, Weill Cornell Medical College, New York, New York, USA.
  • Jivanelli B; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.
  • Athanassoglou V; Department of Anesthesiology, Critical Care and Pain Management, Weill Cornell Medical College, New York, New York, USA.
  • Argyra E; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.
  • Barrington MJ; Department of Anesthesiology, Critical Care and Pain Management, Weill Cornell Medical College, New York, New York, USA.
  • Borgeat A; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.
  • De Andres J; Department of Anesthesiology, Critical Care and Pain Management, Weill Cornell Medical College, New York, New York, USA.
  • El-Boghdadly K; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.
  • Elkassabany NM; Department of Anesthesiology, Critical Care and Pain Management, Weill Cornell Medical College, New York, New York, USA.
  • Gautier P; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.
  • Gerner P; Department of Anesthesiology, Critical Care and Pain Management, Weill Cornell Medical College, New York, New York, USA.
  • Gonzalez Della Valle A; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.
  • Goytizolo E; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.
  • Guo Z; Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Hogg R; Faculty of Medicine, Aretaieion University Hospital, Athens, Greece.
  • Kehlet H; Department of Anesthesiology & Perioperative Medicine, Oregon Health & Science University, Portland, Oregon, USA.
  • Kessler P; Anesthesiology, Balgrist University Hospital, Zurich, Switzerland.
  • Kopp S; Anesthesia, Critical Care and Multidisciplinary Pain Management Department, Valencia University General Hospital, Valencia, Spain.
  • Lavand'homme P; Anesthesia Unit, Surgical Specialties Department, School of Medicine, University of Valencia, Valencia, Spain.
  • Macfarlane A; Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK.
  • MacLean C; Anesthesiology and Critical Care, University Of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Mantilla C; Department of Anesthesiology and Resuscitation, Clinique Sainte-Anne Saint-Remi, Brussels, Belgium.
  • McIsaac D; Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical Private University, Salzburg, Austria.
  • McLawhorn A; Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.
  • Neal JM; Department of Orthopedic Surgery, Weill Cornell Medical College, New York, New York, USA.
  • Parks M; Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA.
  • Parvizi J; Department of Anesthesiology, Critical Care and Pain Management, Weill Cornell Medical College, New York, New York, USA.
  • Peng P; Department of Anesthesiology, Peking Universtiy Shougang Hospital, Beijing, China.
  • Pichler L; Department of Anaesthesia, Belfast Health and Social Care Trust, Belfast, UK.
  • Poeran J; Department of Clinical Medicine, Rigshosp, Copenhagen, Denmark.
  • Poultsides L; Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Hessen, Germany.
  • Schwenk ES; Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Sites BD; Anesthesiology, St Luc Hospital, University Catholic of Louvain, Brussels, Belgium.
Reg Anesth Pain Med ; 46(11): 971-985, 2021 11.
Article en En | MEDLINE | ID: mdl-34433647
ABSTRACT

BACKGROUND:

Evidence-based international expert consensus regarding the impact of peripheral nerve block (PNB) use in total hip/knee arthroplasty surgery.

METHODS:

A systematic review and meta-

analysis:

randomized controlled and observational studies investigating the impact of PNB utilization on major complications, including mortality, cardiac, pulmonary, gastrointestinal, renal, thromboembolic, neurologic, infectious, and bleeding complications.Medline, PubMed, Embase, and Cochrane Library including Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, were queried from 1946 to August 4, 2020.The Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess evidence quality and for the development of recommendations.

RESULTS:

Analysis of 122 studies revealed that PNB use (compared with no use) was associated with lower ORs for (OR with 95% CIs) for numerous complications (total hip and knee arthroplasties (THA/TKA), respectively) cognitive dysfunction (OR 0.30, 95% CI 0.17 to 0.53/OR 0.52, 95% CI 0.34 to 0.80), respiratory failure (OR 0.36, 95% CI 0.17 to 0.74/OR 0.37, 95% CI 0.18 to 0.75), cardiac complications (OR 0.84, 95% CI 0.76 to 0.93/OR 0.83, 95% CI 0.79 to 0.86), surgical site infections (OR 0.55 95% CI 0.47 to 0.64/OR 0.86 95% CI 0.80 to 0.91), thromboembolism (OR 0.74, 95% CI 0.58 to 0.96/OR 0.90, 95% CI 0.84 to 0.96) and blood transfusion (OR 0.84, 95% CI 0.83 to 0.86/OR 0.91, 95% CI 0.90 to 0.92).

CONCLUSIONS:

Based on the current body of evidence, the consensus group recommends PNB use in THA/TKA for improved outcomes. RECOMMENDATION PNB use is recommended for patients undergoing THA and TKA except when contraindications preclude their use. Furthermore, the alignment of provider skills and practice location resources needs to be ensured. Evidence level moderate; recommendation strong.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Cadera / Artroplastia de Reemplazo de Rodilla / Analgesia / Anestesia de Conducción Tipo de estudio: Clinical_trials / Guideline / Observational_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Reg Anesth Pain Med Asunto de la revista: ANESTESIOLOGIA / NEUROLOGIA / PSICOFISIOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Cadera / Artroplastia de Reemplazo de Rodilla / Analgesia / Anestesia de Conducción Tipo de estudio: Clinical_trials / Guideline / Observational_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Reg Anesth Pain Med Asunto de la revista: ANESTESIOLOGIA / NEUROLOGIA / PSICOFISIOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos