To investigate the effect of ultrasound-guided peripheral nerve block (PNB) on postoperative recovery after total hip arthroplasty (THA) or total knee arthroplasty (TKA).

Data were collected from the patients who underwent primary THA or TKA from January2012 to December 2021 in Fujian Provincial Hospital. The patients who were not primary THA or TKA and those who were lost during follow-up or refused to follow up after surgery were excluded. The enrolled patients were divided into PNB and non-PNB groups based on whether they accepted ultrasound-guided peripheral nerve block (PNB). Propensity score matching (PSM) was performed to account for the baseline differences between two groups that were accepted to PNB or not, and postoperativeall-cause mortality at 90 d and one year of the two groups after PSM was also analyzed using Kaplan-Meier survival curve, and the difference in postoperative complications of the two groups after PSM was analyzed using chi square test. In addition, the associations of PNB and the complications were assessed by logistic regression models.

A total of 1 328 patients with THA or TKA were included in this study, of which 197 patients had ultrasound-guided PNB. After 1:1 PSM, 197 matches were successfully completed. Compared with the non-PNB group, patients who accepted PNB had significantly lower all-cause mortality at 90 d after surgery (0% vs 2.5%, χ²=5.046, P=0.025). In addition, the PNB group were associated with a reduced risk of pulmonary complications ［odds ratio (OR)=0.430, 95%confidence interval (95%CI) ( 0.216, 0.857), P=0.033］ and lower extremity deep vein thrombosis ［OR=0.103, 95% CI (0.011, 0.954), P=0.042］.

Ultrasound-guided peripheral nerve block significantly reduces the risk of postoperative pulmonary complications and lower limb deep vein thrombosis in patients with THA or TKA, and is associated with a lower 90-day all-cause mortality.