ArticleAnesthesia and analgesia2013
Neuraxial anesthesia decreases postoperative systemic infection risk compared with general anesthesia in knee arthroplasty.
Article in Anesthesia and analgesia, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 115 citations in OpenAlex.
- Anaesthetic care of patients undergoing primary hip and knee arthroplasty: consensus recommendations from the International Consensus on Anaesthesia-Related Outcomes after Surgery group (ICAROS) based on a systematic review and meta-analysis.British journal of anaesthesia · 2019Pooled it
- Patient, Surgery, and Hospital Related Risk Factors for Surgical Site Infections following Total Hip Arthroplasty.TheScientificWorldJournal · 2015Pooled it
- Anesthetic technique is associated with complication risk and healthcare utilization following total shoulder arthroplasty.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Hemodynamic Stability Between Spinal and General Anesthesia in Patient Undergoing Primary Total Knee Arthroplasty: A Retrospective Study.Anesthesiology research and practice · 2025Article
- Impact of spinal or epidural anaesthesia on perioperative outcomes in adult noncardiac surgery: a narrative review of recent evidence.British journal of anaesthesia · 2024Review
- Underrepresentation of Non-White Participants in the American Academy of Orthopaedic Surgeons Guidelines for Surgical Management of Knee Osteoarthritis.The Journal of arthroplasty · 2024Article
- Article
- Clinical Characteristics of Spinal versus General Anaesthesia in Older Patients Undergoing Hip Fracture Repair Surgery in Jordan: A Multicentre Study.Journal of personalized medicine · 2023Article
- A Retrospective Analysis Investigating Whether Case Volume Experience of the Anesthesiologist Correlates with Intraoperative Efficiency for Joint Arthroplasty.Journal of medical systems · 2023Article
- Patient-related risk factors of prosthetic joint infections following total hip and knee arthroplasty at King Abdulaziz Medical City, a 10-year retrospective study.Journal of orthopaedic surgery and research · 2023Article
- Neuraxial versus general anesthesia for perioperative outcomes and resource utilization following knee arthroplasty: experience from a large national database.Archives of orthopaedic and trauma surgery · 2023Article
- Blood Biomarkers in Patients with Parkinson's Disease: A Review in Context of Anesthetic Care.Diagnostics (Basel, Switzerland) · 2023Review
- Complications following regional anesthesia versus general anesthesia for the treatment of distal radius fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Anesthesia Type and Postoperative Outcomes for Patients Receiving Arthroscopic Rotator Cuff Repairs.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2022Article
- Postoperative Pain Control by Local Infiltration Analgesia and Peripheral Nerve Block in Primary Prosthetic Total Knee Arthroplasty.Rambam Maimonides medical journal · 2022Article
- Spinal anesthesia and hypotensive events in hip fracture surgical repair in elderly patients: a meta-analysis.Journal of anesthesia, analgesia and critical care · 2022Review
- Neuraxial and general anesthesia for outpatient total joint arthroplasty result in similarly low rates of major perioperative complications: a multicentered cohort study.Regional anesthesia and pain medicine · 2022Article
- Development and validation of a Questionnaire to study practices and diversities in Plexus and Peripheral nerve blocks.Indian journal of anaesthesia · 2021Article
- General anesthesia might be associated with early periprosthetic joint infection: an observational study of 3,909 arthroplasties.Acta orthopaedica · 2019Observational
- A Comprehensive Review of Analgesia and Pain Modalities in Hip Fracture Pathogenesis.Current pain and headache reports · 2019Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundSurgical stress has been shown to result in immune disturbance. Neuraxial anesthesia (NA) has long been hypothesized to blunt undesired surgical insults and thus limit immune compromise and improve surgical outcomes. We hypothesized that NA would decrease postoperative infectious complications compared with general anesthesia (GA) among knee arthroplasty patients.
methodsWe studied the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2010. There were 16,555 patients included in our final cohort, with 9167 patients receiving GA and 7388 patients receiving spinal or epidural anesthesia.. Outcomes of interest included infection-related 30-day postoperative complications, including surgical site-related infections, pneumonia, urinary tract infection, sepsis, septic shock, and a composite end point of any systemic infection. Multivariable logistic regression was performed to test for effect of anesthesia type while adjusting for the influence of preexisting comorbidities.
resultsThe overall mortality was 0.24% and 0.15% among NA and GA subjects, respectively (P = 0.214). NA subjects had fewer unadjusted incidences of pneumonia (P = 0.035) and composite systemic infection (P = 0.006). After risk adjustment for preexisting comorbidities, NA was associated with lower odds of pneumonia (odds ratio = 0.51 [95% confidence interval, 0.29-0.90]) and lower odds of composite systemic infection (odds ratio = 0.77 [95% confidence interval, 0.64-0.92]).
conclusionsOur study suggested that NA was associated with lower adjusted odds of both pneumonia and a composite outcome of any systemic infectious complication within 30 days of surgery compared with GA.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.