Postoperative Analgesia with No Motor Block by Continuous Epidural Infusion of Ropivacaine 0.1% and Sufentanil After Total Hip Replacement

The authors performed a meta-analysis and found that epidural analgesia overall provided superior postoperative analgesia compared with intravenous patient-controlled analgesia. For all types of surgery and pain assessments, all forms of epidural analgesia (both continuous epidural infusion and patient-controlled epidural analgesia) provided significantly superior postoperative analgesia compared with intravenous patient-controlled analgesia, with the exception of hydrophilic opioid-only epidural regimens. Continuous epidural infusion provided statistically significantly superior analgesia versus patient-controlled epidural analgesia for overall pain, pain at rest, and pain with activity; however, patients receiving continuous epidural infusion had a significantly higher incidence of nausea-vomiting and motor block but lower incidence of pruritus. In summary, almost without exception, epidural analgesia, regardless of analgesic agent, epidural regimen, and type and time of pain assessment, provided superior postoperative analgesia compared to intravenous patient-controlled analgesia.

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Intrathecal Sufentanil Is More Potent Than Intravenous for Postoperative Analgesia After Total-Hip Replacement

Regional Anesthesia and Pain Medicine ◽

10.1097/00115550-200505000-00007 ◽

2005 ◽

Vol 30 (3) ◽

pp. 249-254 ◽

Cited By ~ 17

Author(s):

Roxane Fournier ◽

Anne Weber ◽

Zdravko Gamulin

Keyword(s):

Total Hip Replacement ◽

Postoperative Analgesia ◽

Hip Replacement ◽

Total Hip

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The modern state of analgesia after total hip replacement

Regional Anesthesia and Acute Pain Management ◽

10.18821/1993-6508-2016-10-4-231-242 ◽

2016 ◽

Vol 10 (4) ◽

pp. 231-242

Author(s):

V. H Timerbaev ◽

N. S Dolgasheva ◽

Pavel G. Genov

Keyword(s):

Total Hip Replacement ◽

Postoperative Analgesia ◽

Hip Replacement ◽

Enhanced Recovery ◽

The Elderly ◽

Regional Analgesia ◽

Wound Infiltration ◽

Aged Patients ◽

Face To Face ◽

Total Hip

Total hip replacement is an important orthopedic surgery allowing to increase high-activity profile and longevity of the elderly patients suffered from arthritis and proximal hip fracture. For the good outcome of the surgery we have to use enhanced recovery strategy which in turn needs performing adequate postoperative analgesia. Using painkillers only (per os, i.v., i.m., s.c.) after THR is not enough to reach this aim (well pain relief at rest and during movement) due to low analgesic potency of the non-opioid drugs and adverse reactions related to opioids, so, the regional analgesia methods are widely spread. Considered before as a gold standard epidural analgesia method is not quite suitable for the aged patients as so as the sympathetic and motor blocks hinder an enhanced recovery after THR. In recent decades the interest in peripheral regional analgesia methods has been gradually increasing. Fascia iliaca and psoas compartment blocks, local wound infiltration analgesia are getting the modern regional THR postoperative analgesia armamentarium. Each of them has some benefits and pitfalls and only face-to-face comparisons within the scope of clinical trials will give us the basic for the constituting the local and national post-THR analgesia guidelines.

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