Table 5

The perioperative impact of anesthesia technique with or without peripheral nerve block use in total knee arthroplasty

ComplicationsPrimary analysisSubgroup analysis
Total OR (95% CI)NObservational OR (95% CI)NRCT OR (95% CI)N
Mortality6 34 48–55 1.07 (0.92 to 1.24)932 1021.07 (0.92 to 1.24)931 4640.64 (0.08 to 4.99)638
Cardiac without MI6 48 51–54 56 57–60 0.83 (0.79 to 0.86)*720 2820.83 (0.79 to 0.86)*719 6030.55 (0.18 to 1.67)679
Myocardial infarction50–52 56 58 62–64 0.57 (0.18 to 1.78)13601080.57 (0.18 to 1.78)1252
Pulmonary6 48 51–53 56 60 62 68–79 148 0.84 (0.79 to 0.89)*721 4690.84 (0.79 to 0.90)*719 8040.57 (0.32 to 1.03)1665
Respiratory failure48 53 60 68–76 148 0.37 (0.18 to 0.75)*12460.46 (0.13 to 1.66)3780.33 (0.14 to 0.79)*868
Pneumonia51 52 56 77–79 1.15 (0.47 to 2.80)7051.15 (0.47 to 2.80)705
Gastrointestinal6 52 53 56 62 64 78 80 148 0.93 (0.83 to 1.04)720 2300.93 (0.83 to 1.04)719 5340.80 (0.40 to 1.63)696
Renal6 48 52 53 64 77 0.96 (0.91 to 1.02)720 1110.96 (0.91 to 1.02)719 6340.77 (0.27 to 2.18)477
Renal failure48 52 53 64 77 0.82 (0.32 to 2.04)6851.00 (0.14 to 7.20)2080.77 (0.27 to 2.18)477
Cognitive Dysfunction48 51 62–64 71 81 84–88 0.52 (0.34 to 0.80)*15630.38 (0.18 to 0.79)*2670.62 (0.37 to 1.03)1196
Delirum48 51 63 81 84 0.44 (0.22 to 0.88)*8990.35 (0.15 to 0.82)*1790.73 (0.21 to 2.51)720
Stroke6 51 62 77 0.95 (0.76 to 1.18)719 7340.94 (0.75 to 1.17)719 4261.99 (0.31 to 12.85)308
Surgical site infection6 48 49 51–53 55 64 70 77 78 85 91–101 149 0.86 (0.80 to 0.91)*796 0900.86 (0.80 to 0.91)*794 2270.79 (0.39 to 1.61)1863
Any infection6 51 52 55 56 77–79 91 102 148 0.77 (0.73 to 0.80)*789 6220.77 (0.73 to 0.80)*788 8070.96 (0.46 to 1.99)815
Sepsis48 52 53 1.37 (0.27 to 7.05)4330.33 (0.01 to 8.21)1002.93 (0.30 to 28.58)333
Thromboembolism6 51–53 55 59 62 64 69 70 77 85 92 93 95 97 98 100 104–107 149 0.90 (0.84 to 0.96)*790 8350.89 (0.84 to 0.95)*789 0551.27 (0.66 to 2.44)1780
Perioperative nerve injury109 1.02 (0.59 to 1.76)85901.02 (0.59 to 1.76)8590
Blood transfusion6 52 53 56 112 113 0.91 (0.90 to 0.92)*1 250 0140.91 (0.90 to 0.92)*1 249 5820.88 (0.41 to 1.87)432
Blood loss†50 53 75 76 80 99 113 119 120 149 −42.53 (−52.08 to −32.98)*890−93.77 mL (−135.11 to −52.43)*147−39.64 mL (−49.46 to −29.83)743
Critical care admission6 49 53 64 1.07 (1.04 to 1.10)*719 7671.07 (1.04 to 1.10)*719 5342.77 (0.11 to 70.23)*233
Readmission34 55 150 0.66 (0.61 to 0.70)*146 4530.66 (0.61 to 0.70)*146 453
Length of stay†34 49–51 56 60 69 70 72–74 77 79 84 85 89 92 101 106 107 110 113 119 124–140 144 149–165 0.02 (−0.01 to 0.04)86 770−0.08 days (−0.12 to −0.05)*83 2490.09 days (0.06 to 0.12)*3521
  • Pulmonary: pulmonary complications excluding pneumonia.

  • All infections: all infections including pneumonia and sepsis.

  • N (NA/GA): total number of patients with neuraxial/general anesthesia.

  • *P<0.05 .

  • †Continuous outcomes reported as mean difference.

  • CNS, central nervous system complications; MI, myocardial infarction; RCT, randomized controlled trial.