THE INFLUENCES OF ANESTHESIA METHODS ON SOME COMPLICATIONS AFTER ORTHOPEDIC SURGERY:

Abstract

Background: Despite various anesthesia techniques explored for orthopedic surgery, addressing anesthesia-related complications remains a challenge. This study aims to investigate how different anesthesia methods impact post-surgical complications in orthopedic procedures. Approach:Anesthesia-related studies in orthopedic surgery were identified through a search of PubMed, Embase, and the Cochrane Library. Data on complications and patient demographics were collected, and study quality was assessed following Cochrane Collaboration guidelines. Network meta-analysis was conducted using
ADDIS software. The pooled effect size was determined using random or consistency models and presented as odds ratios (OR) with 95% confidence intervals (CI). Findings: Twenty-three studies comprising 2393 patients met the inclusion criteria. Quality assessment indicated that all studies were of average quality. Network meta-analyses revealed that nerve block analgesia (NBA) was associated with lower rates of post-operative nausea or vomiting (PONV; OR = 0.17, 95% CI: 0.06–0.39) and urine retention (OR = 0.07, 95% CI: 0.01–0.37) compared to epidural anesthesia (EA). Interscalene block (ISB) and local infiltration analgesia (LIA) significantly reduced the occurrence of back pain compared to EA (OR = 0.00, 95% CI = 0.00–0.30; OR = 0.00, 95% CI = 0.00–0.25). Conclusion: NBA appears effective in reducing PONV and urine retention, while ISB and LIA are effective in alleviating back pain compared to EA following orthopedic surgery. Keywords: Orthopedic surgery, Nerve block analgesia, Local infiltration analgesia, Interscalene block, Complications