Suspected periprosthetic joint infection after total knee arthroplasty under propofol versus sevoflurane anesthesia: a retrospective cohort study.

• Material Type: 博士論文
• Title: Suspected periprosthetic joint infection after total knee arthroplasty under propofol versus sevoflurane anesthesia: a retrospective cohort study.
• Author/Editor: Kishimoto, Miwa; Yamana, Hayato; Inoue, Satoki; Noda, Tatsuya; Akahane, Manabu; Inagaki, Yusuke; Matsui, Hiroki; Yasunaga, Hideo; Kawaguchi, Masahiko; Imamura, Tomoaki
• Author Heading: Kishimoto, Miwa; Yamana, Hayato; Inoue, Satoki; Noda, Tatsuya; Akahane, Manabu; Inagaki, Yusuke; Matsui, Hiroki; Yasunaga, Hideo; Kawaguchi, Masahiko; Imamura, Tomoaki
• Publication, Distribution, etc.: Springer Nature Publishing AG
• Publication Date: 2018-08
• Publication Date (W3CDTF): 2018-08
• Alternative Title: 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
• Periodical title: Canadian journal of anaesthesia
• No. or year of volume/issue: 65 8
• Volume: 65
• Issue: 8
• Pages: 893-900
• ISSN (Periodical Title): ISSN : 0832-610X
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2019-03-15
• Dissertation Number: 甲第700号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Target Audience: 一般
• Note (General): type:Thesis; 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.; 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.; identifier:Canadian journal of anaesthesia Vol.65 No.8 p.893-900 (2018 Aug); identifier:0832610X; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3548; identifier:Canadian journal of anaesthesia, 65(8): 893-900
• Source: fulltext; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3548/1/01%e7%94%b2700%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3548/2/02%e7%94%b2700%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3548/6/03%e7%94%b2700%e6%9c%ac%e6%96%87.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3548/7/04%e7%94%b2700Figure.pdf
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1007/s12630-018-1139-6
• Periodical Title (NCID): AA1066866X; https://ci.nii.ac.jp/ncid/AA1066866X
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU