{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T03:32:27Z","timestamp":1771039947434,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T00:00:00Z","timestamp":1621468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Surgical treatment of ankle fracture is associated with significant pain and high postoperative opioid consumption. The anaesthesia method may affect early postoperative pain. The main objective of the study was to compare postoperative opioid consumption after ankle\u2010fracture surgery between patients treated with spinal anaesthesia and general anaesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed retrospectively the files of 586 adult patients with surgically treated ankle fracture in the years 2014 through 2016. The primary outcome was opioid consumption during the first 48 postoperative hours. Secondary outcomes were maximal pain scores, postoperative nausea and vomiting, the length of stay in the post\u2010anaesthesia care unit, and opioid use in different time periods up to 48\u00a0h postoperatively. Propensity score matching was used to mitigate confounding variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Total opioid consumption 48\u00a0h postoperatively was significantly lower after spinal anaesthesia (propensity score\u2010matched population: effect size \u221213.7 milligrams; 95% CI \u221218.8 to \u22128.5; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). The highest pain score on the numerical rating scale in the post\u2010anaesthesia care unit was significantly higher after general anaesthesia (propensity score\u2010matched population: effect size 3.7 points; 95% CI 3.2\u20104.2; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). A total of 60 patients had postoperative nausea and vomiting in the post\u2010anaesthesia care unit, 53 (88.3%) of whom had general anaesthesia (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with surgically treated ankle fracture whose operation was performed under general anaesthesia used significantly more opioids in the first 48\u00a0h postoperatively, predominantly in the post\u2010anaesthesia care unit, compared with patients given spinal anaesthesia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13845","type":"journal-article","created":{"date-parts":[[2021,5,9]],"date-time":"2021-05-09T06:23:37Z","timestamp":1620541417000},"page":"1109-1115","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Difference in postoperative opioid consumption after spinal versus general anaesthesia for ankle fracture surgery\u2014A retrospective cohort study"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8088-6643","authenticated-orcid":false,"given":"Pasi M.","family":"Lehto","sequence":"first","affiliation":[{"name":"Research Group of Surgery, Anaesthesiology and Intensive Care Medicine Medical Research Center of Oulu University Oulu University Hospital Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4323-4160","authenticated-orcid":false,"given":"Merja A.","family":"Vakkala","sequence":"additional","affiliation":[{"name":"Research Group of Surgery, Anaesthesiology and Intensive Care Medicine Medical Research Center of Oulu University Oulu University Hospital Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4045-7107","authenticated-orcid":false,"given":"Seppo","family":"Alahuhta","sequence":"additional","affiliation":[{"name":"Research Group of Surgery, Anaesthesiology and Intensive Care Medicine Medical Research Center of Oulu University Oulu University Hospital Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5580-3447","authenticated-orcid":false,"given":"Janne H.","family":"Liisanantti","sequence":"additional","affiliation":[{"name":"Research Group of Surgery, Anaesthesiology and Intensive Care Medicine Medical Research Center of Oulu University Oulu University Hospital Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tero H. J.","family":"Kortekangas","sequence":"additional","affiliation":[{"name":"Research Group of Surgery, Anaesthesiology and Intensive Care Medicine Medical Research Center of Oulu University Oulu University Hospital Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaisu","family":"Hiltunen","sequence":"additional","affiliation":[{"name":"Research Group of Surgery, Anaesthesiology and Intensive Care Medicine Medical Research Center of Oulu University Oulu University Hospital Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma\u2010Sofia","family":"Nyman","sequence":"additional","affiliation":[{"name":"Research Group of Surgery, Anaesthesiology and Intensive Care Medicine Medical Research Center of Oulu University Oulu University Hospital Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5125-245X","authenticated-orcid":false,"given":"Timo I.","family":"Kaakinen","sequence":"additional","affiliation":[{"name":"Research Group of Surgery, Anaesthesiology and Intensive Care Medicine Medical Research Center of Oulu University Oulu University Hospital Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31828866b3"},{"key":"e_1_2_8_3_1","first-page":"e021","article-title":"Postoperative pain after surgical treatment of ankle fractures: a prospective study","volume":"2","author":"Chou LB","year":"2018","journal-title":"J Am Acad Orthop Surg"},{"key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jpain.2015.12.008","article-title":"Guidelines on the management of postoperative pain management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists\u2019 Committee on Regional Anesthesia, Executive Committee, and Administrative Council","volume":"2","author":"Chou R","year":"2016","journal-title":"J Pain"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/78.5.606"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew069"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet104"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aev455"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2019.05.042"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.01852"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000335"},{"key":"e_1_2_8_12_1","volume-title":"International statistical classification of diseases and related health problems","author":"World Health Organization","year":"2016"},{"key":"e_1_2_8_13_1","unstructured":"Nordic Medico\u2010Statistical Committee (NOMESCO 2010).NOMESCO Classification of Surgical Procedures (NCSP) version 1.15. 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