ABSTRACT
BACKGROUND AND OBJECTIVES:
Postoperative pain after total hip arthroplasty is moderate to severe and requires effective analgesic techniques. This study aimed at comparing continuous lumbar plexus block and epidural analgesia in patients submitted to hip arthroplasty.
METHODS:
This is a prospective, observational and analytical study of patients submitted to hip arthroplasty in a two-year period, under postoperative analgesia with continuous lumbar plexus block and epidural analgesia. Patients were divided according to the analgesic technique chosen by the anesthesiologist. The protocol consists in continuous perfusion of 0.2% ropivacaine (5mL/h) via continuous lumbar plexus block catheter or 0.1% ropivacaine and fentanil (3μg/mL) (5mL/h) via epidural catheter. Using Acute Pain Unit records, three postoperative days were compared between continuous lumbar plexus block and epidural analgesia with regard to pain intensity, rescue analgesia, complications and hospital stay.
RESULTS:
Participated in the study 162 patients. Most patients of both groups had no pain in the first postoperative day (77.6% continuous lumbar plexus block versus 79.2% epidural). Both groups were not different with regard to pain intensity and need for rescue analgesia (23.5% continuous lumbar plexus block versus 22.1% epidural). Continuous lumbar plexus block group had fewer complications (4.7% versus 23.4%), namely motor block, nausea, vomiting and itching. The low number of complications does not allow the detection of significant differences between techniques. Most patients of both groups were discharged in the third postoperative day.
CONCLUSION:
As compared to epidural analgesia, continuous lumbar plexus block has provided similar analgesia with fewer complications.
Keywords:
Epidural analgesia; Hip arthroplasty; Lumbar plexus block; Postoperative pain.
