A comparison of epidural and non-epidural anesthesia and analgesia in total hip or knee arthroplasty patients.

This retrospective study explores a number of variables encountered with the use of either epidural or non-epidural anesthesia and analgesia. Postoperative mobility, amount of narcotic used, incidence of blood transfusion, length of stay, and presence of urinary retention, pruritus, nausea and vomiting, or respiratory depression were compared in a group of 101 consecutive patients scheduled for total hip or knee arthroplasty. Fifty-two patients received epidural anesthesia and analgesia; the remaining 49 received non-epidural anesthesia, followed by standard IM/IV postoperative analgesia. Epidural patients required significantly less narcotic than the non-epidural group. There were significantly fewer blood transfusions in the epidural group; however, epidural patients had significantly increased incidence of urinary retention and pruritus. The use of epidural anesthesia and analgesia for total hip and knee arthroplasty patients has definite merit, but is most safely administered in a monitored, skilled nursing unit.