title: Increased neurologic complications associated with postoperative epidural analgesia after tibial fracture fixation.
abstract: A retrospective study of 63 patients with surgically treated tibial fractures was performed. The type of postoperative analgesia was compared against the type of fracture, mechanism of injury, type of fixation, adequacy of pain control, and incidence of neurologic complications. The only difference observed among all of these comparisons was that patients given postoperative epidural analgesia with local anesthetics were 4.1 times more likely to have a neurologic complication than those receiving systemic narcotics (P = 0.0496). We conclude that patients who have undergone surgical treatment of tibial plateau or shaft fractures have a significantly higher risk of developing neurologic complications when post-operative epidural analgesia is used.
authors.affiliation: Scott Orthopaedic Center, Huntington, West Virginia, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Iaquinto
authors.forename: D
authors.initials: D
authors.lastname: Pienkowski
authors.forename: R
authors.initials: R
authors.lastname: Thornsberry
authors.forename: S
authors.initials: S
authors.lastname: Grant
authors.forename: D B
authors.initials: DB
authors.lastname: Stevens
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D009460:Neurologic Examination; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010523:Peripheral Nervous System Diseases / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013978:Tibial Fractures / Q000601:surgery*
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D002045:Bupivacaine