The perioperative impact of anesthesia technique with or without peripheral nerve block use in total hip arthroplasty
| Complications | Primary analysis | Subgroup analysis | ||||
| Total OR (95% CI) | N | Observational OR (95% CI) | N | RCT OR (95% CI) | N | |
| Mortality6 48 | 0.61 (0.36 to 1.04) | 342 826 | 0.61 (0.36 to 1.04) | 342 826 | ||
| Cardiac without MI6 48 56 | 0.84 (0.76 to 0.93)* | 342 941 | 0.84 (0.76 to 0.93)* | 342 826 | 0.20 (0.01 to 4.18) | 115 |
| Myocardial infarction56 61 | 1.00 (0.14 to 7.19) | 277 | 1.00 (0.14 to 7.19) | 277 | ||
| Pulmonary6 48 56 65–67 | 0.70 (0.60 to 0.81)* | 343 198 | 0.71 (0.62 to 0.83)* | 342 826 | 0.34 (0.16 to 0.73)* | 372 |
| Respiratory failure48 65–67 | 0.36 (0.17 to 0.74)* | 357 | 0.49 (0.04 to 5.58) | 100 | 0.35 (0.16 to 0.75)* | 257 |
| Pneumonia56 | 0.33 (0.01 to 8.35) | 115 | 0.33 (0.01 to 8.35) | 115 | ||
| Gastrointestinal6 56 | 0.55 (0.43 to 0.70)* | 342 841 | 0.55 (0.43 to 0.70)* | 342 726 | 0.50 (0.04 to 5.67) | 115 |
| Renal6 48 | 0.67 (0.59 to 0.76)* | 342 826 | 0.67 (0.59 to 0.76) | 342 826 | ||
| Renal failure48 | 0.33 (0.01 to 8.21) | 100 | 0.33 (0.01 to 8.21)* | 100 | ||
| Delirium48 65 81–83 141 | 0.30 (0.17 to 0.53)* | 723 | 1.53 (0.24 to 9.59) | 100 | 0.25(0.14 to 0.46)* | 623 |
| Stroke6 | 0.83 (0.53 to 1.29) | 342 726 | 0.83 (0.53 to 1.29) | 342 726 | ||
| Surgical site infection6 48 61 66 | 0.55 (0.47 to 0.64)* | 343 091 | 0.55 (0.47 to 0.64)* | 342 826 | 0.58 (0.08 to 4.47) | 265 |
| Any infection6 56 | 0.71 (0.65 to 0.78)* | 342 841 | 0.71 (0.65 to 0.78)* | 342 726 | 0.33 (0.01 to 8.35) | 115 |
| Sepsis48 66 | 0.32 (0.03 to 3.16) | 203 | 0.33 (0.01 to 8.21) | 100 | 0.32 (0.01 to 8.06) | 103 |
| Thromboembolism6 66 103 142 | 0.74 (0.58 to 0.96)* | 342 955 | 0.73 (0.57 to 0.95)* | 342 726 | 1.73 (0.22 to 13.27) | 229 |
| Perioperative nerve injury108 143 | 0.72 (0.38 to 1.35) | 11 118 | 0.61 (0.30 to 1.26) | 11 118 | ||
| Blood transfusion6 56 83 111 112 | 0.84 (0.83 to 0.86)* | 873 079 | 0.84 (0.83 to 0.86)* | 872 815 | 1.19 (0.66 to 2.16) | 264 |
| Blood loss†142 66 67 83 114–118 | 10.61 (−4.28 to 25.50) | 454 | 40.00 mL (−56.81 to 136.81) | 62 | 9.90 mL (−5.18 t o 24.97) | 392 |
| Critical care admission6 90 | 0.91 (0.86 to 0.95)* | 342 885 | 0.91 (0.86 to 0.95)* | 342 726 | 0.29 (0.01 to 5.77) | 159 |
| Length of stay† 90 144 56 103 118 121–123 145–147 | −0.36 (−0.42 to −0.31)* | 872 | −0.12 days (−0.20 to −0.03)* | 205 | −0.55 days (−0.63 to −0.48)* | 667 |
Pulmonary: pulmonary complications excluding pneumonia.
CNS: central nervous system complications.
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.
MI, myocardial infarction; RCT, randomized controlled trial.