ArticleJournal of hand surgery global online2026
Outcomes After Proximal Humerus Surgery: Does Regional Anesthesia Usage Matter?
Article in Journal of hand surgery global online, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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2 authors.
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Abstract
Purpose: Regional anesthesia is commonly used for intraoperative pain control during proximal humerus fracture surgery. We hypothesized that patients undergoing proximal humerus fracture surgery who received regional anesthesia would have increased postoperative emergency department (ED) utilization, increased perioperative opioid prescriptions, and greater incidence of persistent postoperative opioid prescriptions compared with those who received general anesthesia. Methods: We retrospectively identified patients ≥18 years of age with a closed proximal humerus fracture undergoing either open reduction internal fixation (ORIF) or shoulder arthroplasty within 21 days of the fracture. We used International Classification of Diseases (ICD) 9/10 codes to identify patients using an administrative claims database. We categorized and then propensity-score matched patients based on receipt of regional anesthesia during surgery. Our first outcome was any instance of an ED visit within 7 and 30 days after surgery. Secondary outcomes included perioperative opioid prescriptions and the incidence of persistent opioid prescriptions. Multivariable regression models were used to assess the risk of an ED visit or persistent opioid usage based on the receipt of intraoperative regional anesthesia, adjusting for demographics and comorbidities. Results: In total, 10,580 (33.3%) ORIF patients and 3,299 (33.6%) shoulder arthroplasty patients received regional anesthesia during surgery. Regional anesthesia was associated with an increased 7-day ED visit incidence compared to no regional anesthesia receipt for ORIF patients (3.3% vs 2.3%) and shoulder arthroplasty patients (2.7% vs 1.9%) ( Conclusions: Further research should explore interventions for proximal humerus fracture surgery patients who receive regional anesthesia to reduce potentially preventable ED visits and opioid-related adverse events. Type of study/level of evidence: Therapeutic III.
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