Abstract
Purpose: Sciatic nerve block (SNB) is commonly performed in combination with femoral nerve block (FNB) for postoperative analgesia following total knee arthroplasty (TKA). Despite the fact that 10–20 % of TKA patients require SNB for postoperative posterior knee pain, there are no existing studies that suggest a model to predict the need for SNB. The aim of our study was to develop a prediction tool to measure the likelihood of patients undergoing TKA surgery requiring a postoperative SNB. Methods: With institutional review board approval, we obtained data from the electronic medical record of patients who underwent TKA at the Cleveland Clinic. A multivariable logistic regression was used to estimate the probability of requiring a postoperative SNB. Clinicians selected potential predictors to create a model, and the potential nonlinear association between continuous predictors and SNB was assessed using the restricted cubic spline model. Results: In total 6279 TKA cases involving 2329 patients with complete datasets were used for building the prediction model, including 276 (12 %) patients who received a postoperative SNB and 2053 (88 %) patients who did not. The estimated C statistic of the prediction model was 0.64. The nomogram is used by first locating the patient position on each predictor variable scale, which has corresponding prognostic points. The cut-off of 11.6 % jointly maximizes the sensitivity and specificity. Conclusion: This is the first study to be published on SNB prediction after TKA. Our nomogram may prove to be a useful tool for guiding physicians in terms of their decisions regarding SNB.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 864-872 |
| Number of pages | 9 |
| Journal | Journal of Anesthesia |
| Volume | 30 |
| Issue number | 5 |
| DOIs | |
| State | Published - Oct 1 2016 |
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Keywords
- Nomogram
- Postoperative pain
- Sciatic nerve block
- Total knee arthroplasty
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
A nomogram for predicting the need for sciatic nerve block after total knee arthroplasty. / Babazade, Rovnat; Sreenivasalu, Thilak; Jain, Pankaj; Hutcherson, Matthew T.; Naylor, Amanda J.; You, Jing; Elsharkawy, Hesham; Wael, Ali Sakr Esa; Turan, Alparslan.
In: Journal of Anesthesia, Vol. 30, No. 5, 01.10.2016, p. 864-872.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A nomogram for predicting the need for sciatic nerve block after total knee arthroplasty
AU - Babazade, Rovnat
AU - Sreenivasalu, Thilak
AU - Jain, Pankaj
AU - Hutcherson, Matthew T.
AU - Naylor, Amanda J.
AU - You, Jing
AU - Elsharkawy, Hesham
AU - Wael, Ali Sakr Esa
AU - Turan, Alparslan
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Purpose: Sciatic nerve block (SNB) is commonly performed in combination with femoral nerve block (FNB) for postoperative analgesia following total knee arthroplasty (TKA). Despite the fact that 10–20 % of TKA patients require SNB for postoperative posterior knee pain, there are no existing studies that suggest a model to predict the need for SNB. The aim of our study was to develop a prediction tool to measure the likelihood of patients undergoing TKA surgery requiring a postoperative SNB. Methods: With institutional review board approval, we obtained data from the electronic medical record of patients who underwent TKA at the Cleveland Clinic. A multivariable logistic regression was used to estimate the probability of requiring a postoperative SNB. Clinicians selected potential predictors to create a model, and the potential nonlinear association between continuous predictors and SNB was assessed using the restricted cubic spline model. Results: In total 6279 TKA cases involving 2329 patients with complete datasets were used for building the prediction model, including 276 (12 %) patients who received a postoperative SNB and 2053 (88 %) patients who did not. The estimated C statistic of the prediction model was 0.64. The nomogram is used by first locating the patient position on each predictor variable scale, which has corresponding prognostic points. The cut-off of 11.6 % jointly maximizes the sensitivity and specificity. Conclusion: This is the first study to be published on SNB prediction after TKA. Our nomogram may prove to be a useful tool for guiding physicians in terms of their decisions regarding SNB.
AB - Purpose: Sciatic nerve block (SNB) is commonly performed in combination with femoral nerve block (FNB) for postoperative analgesia following total knee arthroplasty (TKA). Despite the fact that 10–20 % of TKA patients require SNB for postoperative posterior knee pain, there are no existing studies that suggest a model to predict the need for SNB. The aim of our study was to develop a prediction tool to measure the likelihood of patients undergoing TKA surgery requiring a postoperative SNB. Methods: With institutional review board approval, we obtained data from the electronic medical record of patients who underwent TKA at the Cleveland Clinic. A multivariable logistic regression was used to estimate the probability of requiring a postoperative SNB. Clinicians selected potential predictors to create a model, and the potential nonlinear association between continuous predictors and SNB was assessed using the restricted cubic spline model. Results: In total 6279 TKA cases involving 2329 patients with complete datasets were used for building the prediction model, including 276 (12 %) patients who received a postoperative SNB and 2053 (88 %) patients who did not. The estimated C statistic of the prediction model was 0.64. The nomogram is used by first locating the patient position on each predictor variable scale, which has corresponding prognostic points. The cut-off of 11.6 % jointly maximizes the sensitivity and specificity. Conclusion: This is the first study to be published on SNB prediction after TKA. Our nomogram may prove to be a useful tool for guiding physicians in terms of their decisions regarding SNB.
KW - Nomogram
KW - Postoperative pain
KW - Sciatic nerve block
KW - Total knee arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=84982111855&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84982111855&partnerID=8YFLogxK
U2 - 10.1007/s00540-016-2223-0
DO - 10.1007/s00540-016-2223-0
M3 - Article
VL - 30
SP - 864
EP - 872
JO - Journal of Anesthesia
JF - Journal of Anesthesia
SN - 0913-8668
IS - 5
ER -