Background Regional anesthesia (RA) may improve patient-related outcomes, including decreased operative complications, shortened recovery times, and lower hospital readmission rates. More analyses are needed using a diverse set of databases to examine characteristics associated with the receipt of RA.
Methods A national hospital database was queried for patients 18 years or older who underwent total shoulder arthroplasty (TSA), total knee arthroplasty (TKA), anterior cruciate ligament reconstruction (ACLR), carpal tunnel release, ankle open reduction, and internal fixation and arteriovenous fistula creation between January 2016 and June 2021. Regional techniques included neuraxial anesthesia and various upper and lower extremity peripheral nerve blocks to create a binary variable of RA receipt. Univariate statistics were used to compare characteristics associated based on RA receipt and multivariable regression identified factors associated with RA receipt.
Results A total of 51 776 patients were included in the analysis, of which 2111 (4.1%) received RA. Factors associated with decreased odds of RA receipt included black race (vs white race; OR 0.73, 95% CI 0.62 to 0.86), other non-white race (vs white race; OR 0.71, 95% CI 0.61 to 0.86), American Society of Anesthesiologists (ASA) class (vs ASA 1; OR 0.85, 95% CI 0.79 to 0.93), and Medicaid insurance (vs private insurance; OR 0.65, 95% CI 0.51 to 0.82) (all p<0.05). When compared with TKA, ACLR (OR 0.67, 95% CI 0.53 to 0.84), ankle open reduction and internal fixation (OR 0.68, 95% CI 0.58 to 0.81), and carpal tunnel release (OR 0.68, 95% CI 0.59 to 0.78) demonstrated lower odds of RA receipt, whereas TSA (OR 1.31, 95% CI 1.08 to 1.58) demonstrated higher odds of RA receipt (all p<0.05).
Conclusion RA use varies with respect to race, insurance status, and type of surgery.
- REGIONAL ANESTHESIA
Data availability statement
Data are available upon reasonable request. Data are available on request from HCA employees, specifically any of the authors involved in this study.
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Correction notice This article has been corrected since it published Online First. The initial has been added to the last author's name.
Contributors AB helped interpret the data, draft the initial manuscript, and critically revise the manuscript. AB is responsible for the overall content as the guarantor. MC helped with interpretation of the data and critically revised the manuscript. RM helped draft and critically revised the manuscript. JSD helped design the study and interpret the data. MD helped interpret the data, draft the initial manuscript and critically revise the manuscript. NW helped design the study, acquire, analyze, and interpret the data, draft the initial manuscript, and critically revise the manuscript. RG helped design the study, acquire, analyze, and interpret the data, draft the initial manuscript, and critically revise the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests AB, MC, RM, JSD, MD and NW do not have any competing interests to report. RG reports funding for research from Heron Therapeutics, SPR Therapeutics, Infutronics, Ferrosan Medical, and Myoscience.
Provenance and peer review Not commissioned; externally peer reviewed.