Anesthesia Method, Tourniquet Use, and Persistent Postsurgical Pain after Total Knee Arthroplasty: A Prespecified Secondary Analysis of a Randomized Trial

Background Persistent postsurgical pain after total knee arthroplasty is a common problem and major reason for patient dissatisfaction. This secondary analysis aimed to investigate the effects of anesthesia (spinal vs. general) tourniquet use on persistent arthroplasty. Methods In this previously presented parallel, single-center, randomized trial, 404 patients scheduled were spinal versus general no-tourniquet groups. Patients assessed using Brief Pain Inventory–short form preoperatively 3 12 months postoperatively. The prespecified main outcome was change in “average pain” measured with numerical 0 10 rating scale 1 yr threshold clinical importance between groups set 1.0. Results average scores postoperatively did not differ (–2.6 [SD 2.5] –2.3 2.5], respectively; mean difference, –0.4; 95% CI, –0.9 0.1; P = 0.150). group reported smaller decrease than (–2.1 2.7] –2.8 2.3]; 0.6; 0.1 1.1; 0.012). After yr, concerning four severity variables (numerical scale) decreased more (–2.3 2.2] –1.8 2.1]; –0.5; –0.05; 0.029) less (–1.7 2.3] 2.0]; 0.2 1.0; 0.005). None differences reached importance. Conclusions type or has no clinically important effect Editor’s Perspective What We Already Know about Topic Article Tells Us That Is New