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Background <p>Knee arthroplasty is an established treatment for degenerative and inflammatory knee disorders. Effective perioperative analgesia is essential for early mobilisation and same-day discharge. This study evaluated the relationship between different regional anaesthesia techniques, postoperative pain, and same-day discharge rates in knee arthroplasty patients.</p> Methods <p>We evaluated 100 consecutive patients as part of a service evaluation of our established knee arthroplasty pathway. Four regional anaesthesia strategies were used: adductor canal block (ACB) only, ACB + genicular, ACB + IPACK (infiltration of popliteal artery and capsule of the knee), and no block. Pain was assessed using a verbal rating scale (0–3) at 2, 6, 12, and 24&#xa0;h postoperatively. Patient demographics, anaesthetic technique, surgical type and discharge status were recorded. Group comparisons were statistically analysed and predictors of same-day discharge were assessed adjusting for age, gender, BMI, and mean 24-h pain score and surgical type.</p> Results <p>Mean 24-h pain score for the cohort was 1.05 ± 0.81, with women reporting higher scores than men (<i>p</i>-value 0.023). Higher pain scores were independently associated with reduced odds of same-day discharge (OR 0.32, <i>p</i>-value 0.002). Across the four block modalities, mean pain scores did not differ significantly (<i>p</i>-value 0.968). Using no block as the reference, ACB + genicular was associated with higher odds of same-day discharge (OR 5.29, <i>p</i>-value 0.035). Younger age (<i>p</i>-value 0.022) and higher BMI (<i>p</i>-value 0.044) were also significant predictors; gender and ASA grade were not.</p> Conclusion <p>While overall pain scores were similar between block types, higher pain was independently associated with lower likelihood of same-day discharge. In this observational cohort, ACB + genicular was independently associated with same-day discharge following adjustment for confounders. Further work is needed to determine whether these associations are reproducible across centres and patient populations.</p>

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Association between regional anaesthesia strategies, postoperative pain and same-day discharge following knee arthroplasty: a single-centre service evaluation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月2日

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  • D. Yildiz,
  • N. Kader,
  • F. Kashif,
  • S. Radha,
  • K. Mrozek

摘要

Background

Knee arthroplasty is an established treatment for degenerative and inflammatory knee disorders. Effective perioperative analgesia is essential for early mobilisation and same-day discharge. This study evaluated the relationship between different regional anaesthesia techniques, postoperative pain, and same-day discharge rates in knee arthroplasty patients.

Methods

We evaluated 100 consecutive patients as part of a service evaluation of our established knee arthroplasty pathway. Four regional anaesthesia strategies were used: adductor canal block (ACB) only, ACB + genicular, ACB + IPACK (infiltration of popliteal artery and capsule of the knee), and no block. Pain was assessed using a verbal rating scale (0–3) at 2, 6, 12, and 24 h postoperatively. Patient demographics, anaesthetic technique, surgical type and discharge status were recorded. Group comparisons were statistically analysed and predictors of same-day discharge were assessed adjusting for age, gender, BMI, and mean 24-h pain score and surgical type.

Results

Mean 24-h pain score for the cohort was 1.05 ± 0.81, with women reporting higher scores than men (p-value 0.023). Higher pain scores were independently associated with reduced odds of same-day discharge (OR 0.32, p-value 0.002). Across the four block modalities, mean pain scores did not differ significantly (p-value 0.968). Using no block as the reference, ACB + genicular was associated with higher odds of same-day discharge (OR 5.29, p-value 0.035). Younger age (p-value 0.022) and higher BMI (p-value 0.044) were also significant predictors; gender and ASA grade were not.

Conclusion

While overall pain scores were similar between block types, higher pain was independently associated with lower likelihood of same-day discharge. In this observational cohort, ACB + genicular was independently associated with same-day discharge following adjustment for confounders. Further work is needed to determine whether these associations are reproducible across centres and patient populations.