Association of patient characteristics with the receipt of regional anesthesia

• Published in: Regional anesthesia and pain medicine Vol. 48; no. 5; pp. 217 - 223
• Main Authors: Beletsky, Alexander, Currie, Morgan, Shen, Jonathan, Maan, Ramneek, Desilva, Mahesh, Winston, Nutan, Gabriel, Rodney A
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.05.2023; BMJ Publishing Group LTD
• Subjects: analgesia; Anesthesia, Conduction - adverse effects; Arthroplasty, Replacement, Knee; Body mass index; Bone surgery; Classification; Comorbidity; Datasets; EDUCATION; Ethnicity; Fistula; Hernias; Hispanic Americans; Hospitals; Humans; Joint surgery; Lower Extremity - surgery; Medicaid; Medicare; Missing data; Original research; Overweight; Patients; Pediatrics; REGIONAL ANESTHESIA; Regression analysis; Retrospective Studies; Software; Statistical analysis; United States; Variables; White; United States; United States > US; REGIONAL ANESTHESIA; analgesia; EDUCATION
• ISSN: 1098-7339; 1532-8651
• DOI: 10.1136/rapm-2022-103916

BackgroundRegional 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.MethodsA 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.ResultsA 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).ConclusionRA use varies with respect to race, insurance status, and type of surgery.