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Relationship of epidural patient-controlled analgesia with postoperative bleeding after unilateral total knee arthroplasty: a propensity score-matching analysis

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Abstract
Although epidural patient-controlled analgesia (PCA) to control postoperative pain after total knee arthroplasty (TKA), the relationship of epidural PCA with postoperative bleeding remains controversial. Therefore, we aimed to evaluate the effect of epidural and intravenous PCA on postoperative bleeding in patients undergoing unilateral TKA. Total of 2467 patients who underwent TKA were divided to intravenous PCA (n=2339) or epidural PCA (n=128) group. After 1:1 propensity score-matching, 212 patients were analyzed to assess the associations between the perioperative blood loss and epidural PCA between the groups. Mean postoperative blood loss was significantly greater in epidural PCA than in intravenous PCA (900.9 +/- 369.1 mL vs. 737.8 +/- 410.1 mL; P=0.007). The incidence of red blood cell (RBC) administration (>3 units) was significantly higher in epidural PCA than in intravenous PCA (30.2% vs. 16.0%; OR 2.5; 95% CI 1.201-5.205; P=0.014). Epidural PCA may be strongly related to postoperative bleeding and the incidence of RBC transfusion of more than 3 units after unilateral TKA, as compared to intravenous PCA. Therefore, the use of epidural PCA may be carefully considered for postoperative pain management in TKA.
Author(s)
김두환박지훈박한조성식진석준최성수함경돈
Issued Date
2021
Type
Article
Keyword
AnalgesiaArthroplasty (knee)BleedingBloodEpiduralIntravenous administrationJoint replacement surgeryJoint surgeryOsteoarthritisOutcomes researchPain perceptionPatients
DOI
10.1038/s41598-021-90946-5
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7282
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_75fd03cf1cc24100969e31639b86d858&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Relationship%20of%20epidural%20patient-controlled%20analgesia%20with%20postoperative%20bleeding%20after%20unilateral%20total%20knee%20arthroplasty:%20a%20propensity%20score-matching%20an&offset=0&pcAvailability=true
Publisher
SCIENTIFIC REPORTS
Location
영국
Language
영어
ISSN
2045-2322
Citation Volume
11
Citation Number
5
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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