• Zhen Zhang, Chen Li, Zhen-Zhen Xu, Jia-Hui Ma, and Dong-Xin Wang.
• Department of Anesthesiology, Peking University First Hospital, Beijing, China.
• Ann. Surg. 2025 Feb 5.

ObjectiveTo test the hypothesis that peripheral nerve block (PNB) use might be associated with improved perioperative outcomes following major surgery.Summary Background DataPNB has been used to improve postoperative analgesia.MethodsThis was a retrospective cohort study with propensity score matching. We included patients aged ≥65 years who underwent major (≥2 h) non-cardiac thoracic and abdominal surgery under general anesthesia. Data were analyzed according to whether patients received PNB or not during anesthesia. Our primary outcome was the length of hospital stay; secondary outcomes included occurrence of major complications in hospital after surgery.ResultsA total of 1,915 patients were included in the full cohort, of whom 1,316 received PNB and 599 did not; 1,174 patients remained in the cohort after matching, with 587 in each group. Length of hospital stay after surgery was shorter in patients who received PNB than in those who did not (7 days [5 to 9] with PNB vs. 7 days [5 to 11] without PNB: HR 1.15, 95% CI 1.02 to 1.29, P=0.012). When compared with patients who did not receive PNB, those who received PNB developed fewer major complications during hospital stay (RR 0.41, 95% CI 0.30 to 0.58, P<0.001). Patients with PNB required less supplemental analgesia within 72 h (RR 0.70, 95% CI 0.59 to 0.84, P<0.001).ConclusionsUse of PNB was associated with shortened length of hospital stay and reduced major complications in older patients after major non-cardiac thoracic and abdominal surgery, possibly due to improved analgesia.Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.

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