Impact of peripheral nerve blocks on chronic opioid use after elective total knee arthroplasty from a large US claims database
Authors' conclusion
Our results did not show any clinically meaningful differences in postoperative chronic opioid use or dependence across patients receiving single-shot PNB or continuous PNB treatment.
Study context
- Population
- Elective TKA, US Merative MarketScan commercial claims data (2018–22)
- Participants
- 126,860 total knee arthroplasties (TKAs)
- Exposure
- PNB vs no PNB; single-shot vs continuous catheter infusion PNB
- Outcome
- 'Chronic opioid dependence' (>120 pills of opioids prescribed or >10 prescriptions between POD 90 and 180) and 'chronic opioid use' (any opioid refill between POD 90 and 180)
- Follow-up
- POD 90 to 180
Methodological detailsclaims database, multivariable models
- Claims database
- Multivariable models
Main finding
As reported in the abstract
'Chronic opioid dependence'
Observational data: associations, not effects.
Further findings
| Outcome | No PNB | Single-shot PNB | Continuous PNB | OR (95% CI) | P value | |
|---|---|---|---|---|---|---|
| 'Chronic opioid use' (co-primary)Single-shot PNB vs No PNB · multivariable analysis | 12.6% | 13.8% | 14.3% | 1.01 (1.01–1.02) | P < 0.001 | |
| 'Chronic opioid use' (co-primary)Continuous PNB vs No PNB · multivariable analysis | 1.01 (1.01–1.02) | P < 0.001 | ||||
| 0.512Odds ratio (log scale) |
Original publication
Impact of peripheral nerve blocks on chronic opioid use after elective total knee arthroplasty from a large US claims database. Br J Anaesth. Published 30 April 2025. doi:10.
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