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The effect of regional anesthesia blocks on post-operative pain after ambulatory orthopedic trauma surgery

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To determine if regional anesthesia had added benefit to general anesthesia, with or without local anesthesia, in controlling post-operative pain in outpatient orthopedic trauma surgery.

Methods

A retrospective review was performed of prospectively gathered data on 71 patients undergoing outpatient orthopedic trauma surgery. All patients received general anesthesia and an addition 52 patients received additional regional anesthesia. Regional vs. no regional anesthesia groups were compared in terms of post-anesthesia care unit (PACU) pain visual analog scores (VAS), PACU length of stay (LOS), opioid use, and pain control at two weeks.

Results

The regional anesthesia group not differ in demographics or proportion of patients receiving local anesthesia, but was less likely to be undergoing major procedures (13% vs. 37%, proportional difference (PD) − 23%; 95% confidence interval (CI) − 46% to − 0.4%). There were no detectable differences in PACU opioid requirements (median difference (MD) − 7.5 mg, CI − 8 to 0), PACU LOS (MD − 13 min, CI − 63 to 24), discharge pain VAS (MD 0, CI − 1 to 1), post-discharge pain VAS (MD 0, CI − 1 to 1), opioid refills (PD − 6%, CI − 31% to 18%), or patient-perceived pain control (PD − 24%, CI − 41% to 0%). On multivariate analysis, regional anesthesia was the only variable negatively associated with patient-perceived pain control at two weeks (Odds Ratio 0.15; 95% CI 0.03 to 0.8).

Conclusions

Regional anesthesia did not improve post-operative opioid requirements, PACU LOS, or patient-reported pain in the immediate or short-term post-operative period.

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Availability of data and material

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. All data generated or analyzed during this study are included in this published article.

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Funding

No funding was required for the currently submitted project.

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Authors and Affiliations

  1. Department of Orthopaedics, University of Colorado School of Medicine, 12631 E. 17th Avenue, Mail Stop B202, Aurora, CO, 80045, USA

    Diana G. Douleh

  2. Department of Orthopaedics, Denver Health Medical Center, 777 Bannock Street, Denver, CO, 80204, USA

    Lori Chambers & Joshua A. Parry

Authors
  1. Diana G. Douleh
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  2. Lori Chambers
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  3. Joshua A. Parry
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Contributions

DGD, CM, and JAP contributed to conception and design of the study. DGD and LC collected data and organized the database. JAP performed the statistical analysis. DGD wrote the first draft of the manuscript. All authors contributed to manuscript revision, read, and approved the submitted version.

Corresponding author

Correspondence to Diana G. Douleh.

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The authors declare that they do not have any conflict of interest.

Ethics approval

This study was approved by our institutional review board.

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Douleh, D.G., Chambers, L. & Parry, J.A. The effect of regional anesthesia blocks on post-operative pain after ambulatory orthopedic trauma surgery. Eur J Orthop Surg Traumatol 32, 1201–1206 (2022). https://doi.org/10.1007/s00590-021-03079-w

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  • DOI: https://doi.org/10.1007/s00590-021-03079-w

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