• Abhishek Ganta, Nina D Fisher, Kester Gibbons, Sehar Resad Ferati, David Furgiuele, Sanjit R Konda, and Kenneth A Egol.
• NYU Langone Orthopedic Hospital, 301 E 17th St, New York, NY 10003, USA; Jamaica Hospital Medical Center, 8900 Van Wyck Expressway, Richmond Hill, NY 11418, USA. Electronic address: Abhishek.Ganta@nyulangone.org.
• Injury. 2024 Aug 1; 55 (8): 111636111636.

PurposeThe purpose was to compare perioperative outcomes of patients who underwent general or regional anesthesia for intramedullary (IM) nailing of tibial shaft fractures (TSFs).MethodsRetrospective chart review was performed on a consecutive series of low-energy TSF patients who presented to a single academic medical center and a level 1 trauma center who underwent operative repair with a reamed IM nail. Collected information included demographics, injury information, anesthesia type (general or regional i.e. peripheral nerve block), intra-operative opiate consumption (converted to morphine milliequivalents [MME], and post-operative pain visual-analog scale [VAS] pain scores. Patients were divided into 3 groups based on the type of anesthesia received and univariate analysis was performed to compare the 3 groups.ResultsSeventy-six patients were included, with an average age of 44.47±16.0 years. There were 38 (50 %) who were administered general anesthesia and 38 (50 %) who were administered regional anesthesia in the form of a peripheral nerve block. There were no differences between the groups with respect to demographics, medical co-morbidities, rate of open fractures or AO/OTA fracture classification. Regional anesthesia patients received less intra-operative MME than general anesthesia patients (17.57±10.6, 28.96±13.8, p < 0.001). Patients who received regional anesthesia also spent less time in the operating room, received less MME on post-operative day 1, and ambulated further on post-operative day 1, however none of these differences were statistically significant. There were no cases of missed post-operative compartment syndrome or complications related to the administration of the peripheral nerve block.ConclusionsRegional anesthesia in TSF surgery received less intra-operative opioid requirements, without any untoward effects.Level Of EvidenceTherapeutic Level III.Copyright © 2024 Elsevier Ltd. All rights reserved.

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