Comparative effects of different anesthetic techniques on postoperative intravenous analgesia and related complications

Abstract

Objective: To systematically compare the effects of general anesthesia alone and general anesthesia combined with peripheral nerve block on postoperative analgesic efficacy, complications, and early recovery in patients undergoing hip or knee arthroplasty. Methodology: This single-center retrospective cohort study included 170 patients who underwent hip or knee joint replacement at Zhongshan Hospital(Xiamen), Fudan University between January 2023 and January 2026. According to the anesthetic technique used, patients were classified as the general anesthesia group (GA group, n= 85) or the general anesthesia plus nerve block group (GA+NB group, n= 85). All patients received standardized intravenous patient-controlled analgesia (IV-PCA) postoperatively. Scores on the resting visual analogue scale (VAS) were recorded immediately in the Post-Anesthesia Care Unit and at 24 hours and 48 hours postoperative. Results: Resting VAS scores at all postoperative time points were significantly lower in the GA+NB group compared with the GA group(all P< 0.05). Within 48 hours postoperative, the GA+NB group showed fewer effective PCA demands and a lower rate of rescue analgesia than the GA group(both p< 0.05). The incidences of postoperative nausea and vomiting and pruritus were also significantly reduced in the GA+NB group(both p< 0.05). Patient satisfaction was significantly higher in the GA+NB group than in the GA group (P = 0.038). Conclusion: In patients undergoing joint arthroplasty, the intraoperative use of general anesthesia combined with peripheral nerve block, followed by postoperative IV-PCA, appears to deliver superior analgesia. This approach can significantly reduce opioid-related adverse effects and improve patient satisfaction.