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Postoperative pain relief after total hip arthroplasty : a randomized, double-blind comparison between intrathecal morphine and local infiltration analgesia
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- Kuchalik, Jan (författare)
- Dept Anaesthesiol & Intens Care, Örebro University Hospital, Örebro, Sweden; Inst Med & Hlth, Örebro University Hospital, Örebro, Sweden
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- Granath, B. (författare)
- Dept Orthopaed Surg, Örebro University Hospital, Örebro, Sweden; Inst Med & Hlth, Örebro University Hospital, Örebro, Sweden
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- Ljunggren, A. (författare)
- Dept Anaesthesiol & Intens Care, Örebro University Hospital, Örebro, Sweden
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- Elsevier BV, 2013
- 2013
- Engelska.
- Ingår i: British Journal of Anaesthesia. - : Elsevier BV. - 0007-0912 .- 1471-6771. ; 111:5, s. 793-799
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- Postoperative pain after total hip arthroplasty (THA) can delay mobilization. This was assessed after intrathecal morphine (ITM) compared with local infiltration analgesia (LIA) using a non-inferiority design. Eighty patients were recruited in this randomized, double-blind study. ITM 0.1 mg (Group ITM) or periarticular local anaesthetic (ropivacaine 300 mg)ketorolac 30 mg epinephrine 0.5 mg (total volume 151.5 ml) (Group LIA) were compared. After 24 h, 22 ml of saline (Group ITM) or ropivacaine (150 mg)ketorolac (30 mg)epinephrine (0.1 mg) (Group LIA) were injected via a catheter. After operation, rescue analgesic consumption, pain intensity, and home-readiness were measured. Morphine consumption was equivalent, median difference 0 mg (95 confidence interval 4 to 4.5) between the groups at 024 h. During 2448 h, it was lower in Group LIA (3 mg, 060 mg, median, range) compared with Group ITM (10 mg, 081 mg) (P0.01). Lower pain scores were recorded at rest at 8 h in Group ITM (P0.01), but in Group LIA on standing and mobilization, at 2448 h (P0.01). Paracetamol and tramadol consumption was lower in Group LIA (P0.05 and 0.05, respectively) as was pruritus, nausea, and vomiting (P0.05). Lower pain intensity was recorded early after surgery in ITM group but later, analgesic consumption, pain intensity on mobilization, and side-effects were lower in patients receiving LIA. LIA is a good alternative to ITM in patients undergoing THA.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Nyckelord
- analgesic techniques
- infiltration
- pain
- postoperative
- surgery
- orthopaedic
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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- British Journal of Anaesthesia (Sök värdpublikationen i LIBRIS)
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- Kuchalik, Jan
- Granath, B.
- Ljunggren, A.
- Magnuson, A.
- Lundin, Anders
- Gupta, Anil
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