Abstract:
BACKGROUND:Postanesthesia care is a costly component of overall surgical care. In the ambulatory setting, regional anesthesia has been shown for multiple surgical procedures to either decrease postanesthesia care unit (PACU) length of stay (LOS) or completely bypass it altogether. This has not been demonstrated in a large hospital setting with a complex surgical case mix. QUESTIONS/PURPOSES:We therefore determined whether regional anesthesia was associated with a reduced PACU LOS among patients undergoing inpatient and outpatient surgery in a large tertiary-care teaching hospital. Secondary study questions included risk factors for longer PACU LOS and any possible interaction between regional and general anesthesia as it might have affected PACU LOS. METHODS:We performed a matched retrospective study on patients who had surgery at our institution and were admitted to the PACU immediately after leaving the operating room. We analyzed between January 1, 2005, and January 1, 2013, with one cohort receiving regional anesthesia, with or without general anesthesia, and the other receiving no regional anesthesia. We measured the association between regional anesthesia and time to successful PACU discharge using a Cox multivariate proportional-hazards model. RESULTS:After controlling for potentially confounding variables, including patient age, American Society of Anesthesiologists' physical classification, and duration of surgery (using multivariate analysis), there was no difference in the time to successful PACU discharge between patients who received regional anesthesia and those who did not. However, when compared to those who received general anesthesia, regional anesthesia was associated with decreased PACU LOS. Further, there was significant effect modification between regional and general anesthesia; patients who received both regional and general were more likely to be successfully discharged faster from the PACU than patients who received only general anesthesia (hazard ratio = 1.50, 95% CI = 1.46-1.55, p < 0.001). CONCLUSIONS:We demonstrated that independently, regional anesthesia is not associated with a reduced PACU LOS in an unselected population at a large tertiary-care hospital, but regional is favored when compared to general anesthesia. Whether the differences are clinically important, and in what procedures they are most pronounced, would be reasonable questions for future prospective comparative trials. LEVEL OF EVIDENCE:Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Corey JM,Bulka CM,Ehrenfeld JMdoi
10.1007/s11999-013-3336-5subject
Has Abstractpub_date
2014-05-01 00:00:00pages
1427-33issue
5eissn
0009-921Xissn
1528-1132journal_volume
472pub_type
杂志文章abstract::This Classic Article is a reprint of the original work by T. W. Huntington, Case of bone transference. Use of a segment of fibula to supply a defect in the tibia. An accompanying biographical sketch of T. W. Huntington is available at DOI 10.1007/s11999-012-2495-0 . The classic article is 1905 and is reprinted courtes...
journal_title:Clinical orthopaedics and related research
pub_type: 传,古典文章,历史文章,杂志文章
doi:10.1007/s11999-012-2496-z
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Patellofemoral osteoarthritis (OA) and anterior knee pain sometimes are considered contraindications for unicompartmental knee arthroplasty (UKA). However, several studies have demonstrated excellent patient-reported outcome scores in patients with patellofemoral OA treated with medial mobile-bearing UKA. Be...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000000738
更新日期:2019-09-01 00:00:00
abstract::The bone mineral content in the shafts of the forearm in 17 women with cervical fracture of the upper end of the femur was low. The cortex of the femoral neck was also lower than normal. Thus women with hip fractures at an early age may have lower than average total skeletal tissue density. This may be due not simply ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-05-01 00:00:00
abstract::In 1958 a group of Swiss general and orthopaedic surgeons established the AO (Arbeitsgemeinschaft für Osteosynthesefragen) or the Association of the Study of Internal Fixation (ASIF) to strive to transform the contemporary treatment of fractures in Switzerland. This association was revolutionary in development of inst...
journal_title:Clinical orthopaedics and related research
pub_type: 传,历史文章,杂志文章
doi:
更新日期:1998-02-01 00:00:00
abstract::Between 1976 and 1992, reinfection developed in 34 patients treated for an infected total hip arthroplasty with removal of the prosthesis and implantation of another prosthesis. These patients included 15 men and 19 women with a mean age of 62 years. Infection recurred an average of 2.2 years after reimplantation of t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199705000-00026
更新日期:1997-05-01 00:00:00
abstract::Joint synovia and fluids taken from patients with various stages of rheumatoid arthritis (RA) were injected into embryonated chicken eggs, resulting in characteristic joint abnormalities ("crooked toes") in the extremities of the embryos and chicks. There was a direct correlation between the number of the induced lesi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1979-10-01 00:00:00
abstract::In the majority of skeletal metastases, new bone develops simultaneously with bone destruction. The roentgenogram indicates the net effect of these two processes. Where the bone formation predominates, the lesion appears sclerotic. Where bone destruction predominates, it appears lytic. Mixed lesions may also occur. Th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-09-01 00:00:00
abstract::Bone remodeling after cementless total hip arthroplasty was evaluated by dual energy x-ray absorptiometry in a longitudinal study of 32 hips. After insertion of a fully porous surface anatomic stem made of cobalt chromium, bone mineral density was analyzed until at least 2 years postoperatively. Bone remodeling was ev...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199706000-00017
更新日期:1997-06-01 00:00:00
abstract::Tendinopathy is a common clinical problem with athletes and in many occupational settings. Tendinopathy can occur in any tendon, often near its insertion or enthesis where there is an area of stress concentration, and is directly related to the volume of repetitive load to which the tendon is exposed. Recent studies i...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-008-0286-4
更新日期:2008-07-01 00:00:00
abstract::Three cases of an isolated femoral component failure of a hip surface replacement were treated by use of a press-fit bipolar prosthesis to articulate with the retained acetabular cup. At two to three years post-surgery (average, 31 months), these three conversions had good clinical function and maintained an acceptabl...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-07-01 00:00:00
abstract:UNLABELLED:Computer-navigated and minimally invasive TKAs are emerging technologies that have distinct strengths and weaknesses. We compared duration of surgery, length of hospitalization, Knee Society scores, radiographic alignments, and complications in two unselected groups of 81 consecutive knees that underwent TKA...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0429-7
更新日期:2008-11-01 00:00:00
abstract::Mesenchymal neoplasms are a heterogeneous group of tumors comprising more than 200 benign entities and approximately 100 sarcomas. Large intraobserver and interobserver variability mandates improvements in diagnostic criteria. Gene expression microarrays are one tool in an evolving field of technology that permits the...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000093897.12372.88
更新日期:2003-10-01 00:00:00
abstract::The treatment of 19 congenitally dislocated knees in 11 patients is reviewed. The knees were subdivided into genu recurvatum, subluxation and dislocation. Nine knees were treated conservatively and ten surgically. A good result was obtained with conservative treatment if started before the age of three months; after t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-03-01 00:00:00
abstract::Despite a standardized operative technique and appropriate patient selection for physeal bar resection, a bar size less than 50% of the physis, and a prospective growth period greater than 2 years, failure may result. Limited growth because of poor function of the remaining physis and secondary tethers (incomplete res...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200212000-00031
更新日期:2002-12-01 00:00:00
abstract::Articular cartilage repair remains a clinical and scientific challenge with increasing interest focused on the transplantation of chondrogenic cells. This study evaluated the repair response during a 1-year period after implantation of allogenic perichondrium cell polylactic acid composite grafts into 3.7 x 5 mm osteo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199707000-00029
更新日期:1997-07-01 00:00:00
abstract::Radial polydactyly, a common congenital problem, most often occurs as thumb duplication. It appears in pentadactylous, polydactylous, and hypoplastic hands and is simulated by complex syndactyly. Classically, there are three categories for radial polydactyly: severe hypoplasia, partial duplication, and total duplicati...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1985-05-01 00:00:00
abstract::Surgery to treat old injuries of the pelvis was performed to reconstruct the pelvic ring (its anterior and posterior compartments) using autoplastic materials and various fixators. The reconstructive operation for extensive disjunction of the pubic symphysis and sacroiliac joint is performed in three stages. The first...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract::Microfilaments, especially actin, have been demonstrated in a variety of noncontractile cells. In earlier studies, the quantity as well as the distribution of these microfilaments has been used to differentiate normal murine fibroblasts from virally transformed cells. This study examines these differences in cells fro...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-11-01 00:00:00
abstract::A rare case of anterior slip of the capital femoral epiphysis demonstrates that the mechanism of the posterior, inferior slip of the capital femoral epiphysis is a combination of weight bearing in the frontal plane and muscle pull in the horizontal plane. Sudden violent motions cause some of the unusual positions of a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-197507000-00022
更新日期:1975-07-01 00:00:00
abstract::Mini-incision total knee arthroplasty can be accomplished through versions of exposures used in standard total knee arthroplasty. Modifications of the medial parapatellar, subvastus, and midvastus approaches are presented, and potential advantages and disadvantages of each approach are reviewed. When making the transi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000148574.79874.d0
更新日期:2004-11-01 00:00:00
abstract:UNLABELLED:Ten patients who had reconstruction of the acromion and deltoid in a painful dysfunctional shoulder after an acromionectomy were reviewed with respect to pain, range of motion, strength, patients' satisfaction, and complications. There were four total acromionectomies, five subtotal acromionectomies, and one...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章
doi:10.1097/01.blo.0000146535.77776.5f
更新日期:2005-01-01 00:00:00
abstract::Treatment options for giant cell tumors of the distal tibia include curettage and cement packing, curettage and bone grafting, or resection and reconstruction for aggressive tumors. Curettage of aggressive tumors often leads to severe bone loss requiring reconstruction. Allograft and autograft may be effective options...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-1097-y
更新日期:2010-06-01 00:00:00
abstract::Femoral impaction allografting has been done with and without variations of the original description. The purpose of this study was to review Harris hip scores, radiographs, and complications in patients in whom we used the original technique without significant modifications. Preoperative and postoperative hip scores...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章
doi:10.1097/01.blo.0000150320.73465.82
更新日期:2005-03-01 00:00:00
abstract::Intracapsular fractures of the hip have been classified by different authors with a basis on various concepts. Pauwels classified these fractures according to the angle of inclination; Linton used trabecular disposition among the fractural fragments, and Garden described four types according to the order of displaceme...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-200206000-00004
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:During hip arthroplasties for treating proximal femur metastases, a long femoral stem frequently is used, presumably protecting the entire femur against progression of the existing lesions or development of new lesions. However, it is unclear whether a long stem is really required. QUESTIONS/PURPOSES:We the...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-2790-4
更新日期:2013-05-01 00:00:00
abstract::The response of protodifferentiated and differentiated bone cells to bovine bone morphogenetic protein (bBMP) was observed in implants in the adult rabbit distal femoral metaphysis. Bovine serum albumin and denatured bBMP were implanted in the contralateral femur of controls. The changes of the bone marrow reflected t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-05-01 00:00:00
abstract:BACKGROUND:Alternative dispute resolution (ADR) refers to techniques used to resolve conflicts without going to the courtroom. As healthcare and malpractice costs continue to rise, there is growing interest in tactics such as early apology, mediation, and arbitration in the medical arena. QUESTIONS/PURPOSES:(1) Why is...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2206-2
更新日期:2012-05-01 00:00:00
abstract::A heterogeneous group of 17 patients with aseptic necrosis of the femoral head had treatment of 23 hips by bone grafting. Phemister-type tibial grafts were used in 20 and iliac grafts in 3. All hips were evaluated before and after grafting according to roentgenographic stage of disease and the Hospital for Special Sur...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract:UNLABELLED:To augment cement-bone bonding, we interposed hydroxyapatite granules at the cement-bone interface (bioactive bone cement technique). Hydroxyapatite granules (2-3 g) were smeared on the bone surface of the acetabulum and femur just before cementing. We used porous hydroxyapatite granules 300 to 500 microm in...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-007-0057-7
更新日期:2008-02-01 00:00:00
abstract::The incidence of fractures in primary hyperparathyroidism is highly variable. The possibility that there might be an increased susceptibility to fracture is discussed. Healing in most is without delay. Three cases of delayed or nonunion following fracture are presented. In all three, healing accelerated dramatically a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-05-01 00:00:00