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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3548

Title: Suspected periprosthetic joint infection after total knee arthroplasty under propofol versus sevoflurane anesthesia: a retrospective cohort study.
Other Titles: 人工膝関節置換術後の関節周囲感染が疑われる症例の発生頻度は、術中麻酔維持使用薬剤の選択と関連するか(プロポフォールによる全静脈麻酔と、セボフルランでの麻酔維持での比較):後ろ向きコホート研究
Authors: Kishimoto, Miwa
Yamana, Hayato
Inoue, Satoki
Noda, Tatsuya
Akahane, Manabu
Inagaki, Yusuke
Matsui, Hiroki
Yasunaga, Hideo
Kawaguchi, Masahiko
Imamura, Tomoaki
Issue Date: Aug-2018
Publisher: Springer
Citation: Canadian journal of anaesthesia Vol.65 No.8 p.893-900 (2018 Aug)
Abstract: PURPOSE: Periprosthetic joint infection is a serious complication of total knee arthroplasty. Though there are many factors that might increase its risk, the use of propofol for maintaining general anesthesia could theoretically increase the incidence of infection because of its lipid component that supports bacterial growth. Nevertheless, the relationship between anesthetic maintenance agents and the occurrence of periprosthetic joint infection remains uncertain. The purpose of this study was to compare the incidence of suspected early-onset periprosthetic joint infection between patients undergoing total knee arthroplasty under propofol vs sevoflurane anesthesia. METHODS: We conducted a retrospective cohort study of patients in the national inpatient Diagnosis Procedure Combination database in Japan who underwent total knee arthroplasty. Suspected periprosthetic joint infection was surrogately defined as the need for arthrocentesis or debridement within 30 days of surgery. Propensity score matching was performed between patients who received either propofol or sevoflurane for anesthetic maintenance to determine the proportion of those with infection. RESULTS: Eligible patients (n = 21,899) were categorized into either the propofol (n = 7,439) or sevoflurane (n = 14,460) groups. In the 5,140 propensity-matched patient pairs, there was no significant difference in the proportion of arthrocentesis or debridement [1.3% propofol vs 1.7% sevoflurane; respectively (relative risk, 0.76; 95% CI, 0.55 to 1.04; P = 0.10)] between the groups. The mean (SD) length of stay in the propofol group was significantly longer than in the sevoflurane group [32.5 (18.4) days vs 31.4 (14.4) days, respectively; mean difference, 1.1; 95% CI, 0.5 to 1.8; P < 0.001]. CONCLUSION: Propensity score analysis suggested no significant association between the choice of anesthetic maintenance agent and the occurrence of suspected early-onset periprosthetic joint infection in patients undergoing total knee arthroplasty.
Description: 博士(医学)・甲第700号・平成31年3月15日
© Canadian Anesthesiologists' Society 2018
This is a post-peer-review, pre-copyedit version of an article published in Canadian journal of anaesthesia. The final authenticated version is available online at: http://dx.doi.org/10.1007/s12630-018-1139-6.
発行元が定める登録猶予期間終了の後、本文を登録予定(2019.08)
URI: http://hdl.handle.net/10564/3548
ISSN: 0832610X
Academic Degrees and number: 24601A700
Degree-granting date: 2019-03-15
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2018年度

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