National patterns and variation in regional anesthesia use for shoulder, hip, knee, and ankle arthroplasty: a National Inpatient Sample analysis
Authors' conclusion
There is notable variation in RA use for inpatient arthroplasty across hospitals and geographic regions, with limited variation based on patient characteristics.
Study context
- Population
- Adults undergoing shoulder, hip, knee and ankle arthroplasty, US National Inpatient Sample, 2016–2020
- Participants
- 1,132 011 unweighted admissions
- Exposure
- Regional anesthesia (RA) utilization by procedure type and by patient-level and hospital-level characteristics
- Outcome
- RA utilization (procedure codes for neuraxial anaesthesia and peripheral nerve blocks)
Methodological detailsNational Inpatient Sample, weighted analysis
- National Inpatient Sample
- Weighted analysis
Main finding
As reported in the abstract
RA utilization
- RA used overall
- 7.0%
Observational data: associations, not effects.
Further findings
| Outcome | Shoulder | Hip | Knee | Ankle |
|---|---|---|---|---|
| Variation in RA use by hospital size | ||||
| SMD | 0.13 | 0.29 | 0.22 | — not stated in the abstract |
| Variation in RA use by hospital location and teaching status | ||||
| SMD | 0.17 | 0.18 | 0.19 | 0.12 |
| Variation in RA use by geographic region | ||||
| SMD | 0.26 | 0.45 | 0.24 | 0.17 |
— not stated in the abstract
Variation in RA use by patient characteristics (ankle arthroplasty)
- Race, SMD
- 0.11
- Primary payer, SMD
- 0.12
- SMD ≥0.10 indicates meaningful difference
Original publication
National patterns and variation in regional anesthesia use for shoulder, hip, knee, and ankle arthroplasty: a National Inpatient Sample analysis. Reg Anesth Pain Med. Published 10 June 2026. doi:10.
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