title: Spinal Anesthesia Improves Early Pain Levels After Surgical Treatment of Tibial Plateau Fractures.
abstract: OBJECTIVE
  To determine the effect of spinal anesthesia (SA) on short-term outcomes when compared with general anesthesia in operatively managed tibial plateau fractures.
  
  
  METHODS
  This is an institutional review board-approved retrospective review of prospectively collected data.
  
  
  METHODS
  Two level-1 trauma centers.
  
  
  METHODS
  One hundred twelve patients with a surgically managed tibial plateau fracture were identified within a registry of patients.
  
  
  METHODS
  Of these, 29 (25.9%) received SA and 83 (74.1%) received general anesthesia in a nonrandomized fashion.
  
  
  METHODS
  Short Musculoskeletal Functional Assessment scores, pain levels, knee range of motion, complications, and reoperations.
  
  
  RESULTS
  SA was found to be a predictor of lower pain scores at 3 months (odds ratio, 0.32; 95% confidence interval, 0.12-0.95; P = 0.039) but not at 6 months (P = 0.266) or the latest follow-up (P = 0.056). In the multivariate Short Musculoskeletal Functional Assessment model, although anesthesia type was not found to be a statistically significant predictor, other predictors were identified. Anesthesia type was not a predictor of complications or reoperations. In the univariate analysis, SA was associated with an increased knee range of motion at 3 months (121 vs. 111 degrees; P = 0.048) but not at 6 months (P = 0.31) or the latest follow-up (P = 0.053).
  
  
  CONCLUSIONS
  In patients who undergo surgical management of a tibial plateau fracture, the use of SA is associated with decreased pain levels in the early postoperative period; however, there was no effect on functional assessment scores.
  
  
  METHODS
  Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery NYU Hospital for Joint Diseases, New York, NY.
authors.forename: Arthur
authors.initials: A
authors.lastname: Manoli
authors.forename: Arthur
authors.initials: A
authors.lastname: Atchabahian
authors.forename: Roy I
authors.initials: RI
authors.lastname: Davidovitch
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Egol
mesh_terms: D000768:Anesthesia, General / Q000706:statistics & numerical data*; D000775:Anesthesia, Spinal / Q000706:statistics & numerical data*; D015984:Causality; D015897:Comorbidity; D005260:Female; D005593:Fracture Fixation, Internal / Q000706:statistics & numerical data; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D010147:Pain Measurement / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D013978:Tibial Fractures / Q000453:epidemiology* / Q000601:surgery*; D016896:Treatment Outcome