OBJECTIVES: In this study, the effects of lumbar plexus block and epidural block on total blood loss and postoperative analgesia in patients undergoing total hip arthroplasty (THA) under general anesthesia was documented. METHODS: The study included 45 patients undergoing THA under general anesthesia. Group GA (n=15) received general anesthesia, Group GA+E (n=15) received general anesthesia + epidural catheter and Group GA+LPB (n=15) received general anesthesia + lumbar plexus catheterization. Intraoperative blood transfusion (IOBT) requirements and intraoperative bleeding (IOB) were documented. Postoperative hemoglobin, hematocrit and total blood loss through the drains were also documented. All patients received patient-controlled analgesia through the IV route. Time to first analgesic requirement (TFAR), total IV morphine consumption (MORPH 24) and 24-hour visual analogue scale (VAS) values were evaluated. RESULTS:TFAR was the lowest (8.7+/-4.0 min.) in the GA group and highest (42.7+/-14.4 min) in the GA+LPB group, and the GA+E group had lower values than the GA+LPB (32.3+/-16.0 min) group (p<0.05). IOBT, IOB, and MORPH 24 average values were the lowest in the GA+LPB group and highest in the GA group, with GA+E in between (p<0.05). Postoperative first VAS values were significantly different between the GA group and the others (p<0.001). There was also a significant difference between the GA group and the others regarding postoperative average Hb values (p<0.02). CONCLUSION: THA using either regional technique provides less blood loss and better analgesia. We will consider LPB in our future cases in view of the lower intraoperative blood loss and better analgesia.
RCT Entities:
OBJECTIVES: In this study, the effects of lumbar plexus block and epidural block on total blood loss and postoperative analgesia in patients undergoing total hip arthroplasty (THA) under general anesthesia was documented. METHODS: The study included 45 patients undergoing THA under general anesthesia. Group GA (n=15) received general anesthesia, Group GA+E (n=15) received general anesthesia + epidural catheter and Group GA+LPB (n=15) received general anesthesia + lumbar plexus catheterization. Intraoperative blood transfusion (IOBT) requirements and intraoperative bleeding (IOB) were documented. Postoperative hemoglobin, hematocrit and total blood loss through the drains were also documented. All patients received patient-controlled analgesia through the IV route. Time to first analgesic requirement (TFAR), total IV morphine consumption (MORPH 24) and 24-hour visual analogue scale (VAS) values were evaluated. RESULTS:TFAR was the lowest (8.7+/-4.0 min.) in the GA group and highest (42.7+/-14.4 min) in the GA+LPB group, and the GA+E group had lower values than the GA+LPB (32.3+/-16.0 min) group (p<0.05). IOBT, IOB, and MORPH 24 average values were the lowest in the GA+LPB group and highest in the GA group, with GA+E in between (p<0.05). Postoperative first VAS values were significantly different between the GA group and the others (p<0.001). There was also a significant difference between the GA group and the others regarding postoperative average Hb values (p<0.02). CONCLUSION: THA using either regional technique provides less blood loss and better analgesia. We will consider LPB in our future cases in view of the lower intraoperative blood loss and better analgesia.
Authors: Dylan B Combs; Amelia Hummel; Scott T Nishioka; Samantha N Andrews; Cass K Nakasone Journal: Arch Orthop Trauma Surg Date: 2022-08-22 Impact factor: 2.928