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Comparative study between ultrasound-guided lumbar paravertebral block and lumbar epidural block with ropivacaine for postoperative pain relief in patient undergoing total hip replacement surgery: A prospective randomised, double-blind study

Comparative study between ultrasound-guided lumbar paravertebral block and lumbar epidural block... AbstractBackgroundTotal hip replacement (THR) is mostly performed in patients above 65 years of age. Patients of this age group typically have comorbidities, therefore safe techniques for anaesthesia and analgesia with minimal side effects should be chosen and should allow early mobilisation. Lumbar paravertebral block is less explored in this domain. The primary objective of this study is to compare the efficacy of ultrasound-guided lumbar paravertebral and epidural block using ropivacaine (0.25%) with fentanyl as adjuvant for postoperative pain in patients undergoing unilateral THR.Settings and DesignRandomised, controlled, double-blind, prospective study carried out in the Department of Anaesthesiology at Banaras Hindu University.Methods and MaterialAfter receiving institutional ethical committee clearance and written informed consent from patients, this study was carried out from February 2019 to February 2020. Sixty adult patients who required THR and fulfilled the inclusion criteria were randomised into two groups. The thirty patients in Group A received a continuous infusion of 5 ml/hr (0.25%) ropivacaine + 2 mcg/ml fentanyl via lumbar epidural catheter. The thirty patients in Group B received a continuous infusion of 5 ml/hr (0.25%) ropivacaine + 2 mcg/ml fentanyl via lumbar paravertebral catheter. Visual analogue scale (VAS) was used to evaluate pain scores. Rescue analgesia use and duration of hospital stay was calculated and compared in postoperative period. The statistical analysis of data was done by using software Statistical Package for Social Sciences SPSS for Windows (Version 23.0), and chi-square test was used for categorical variables. To compare the two groups of mean Student’s t-test and for more than two groups one-way analysis of variance, the ANOVA test was used.ResultsIn Group A, 16.7% patients required rescue analgesic, and in Group B, 26.7% required rescue analgesia which is comparable and non-significant. The mean duration of hospital stay in Group A is 7.50 days. Compared to 6.47 days in Group B, this difference is statistically significant (p-0.000).ConclusionsAnalgesia provided by paravertebral block is not superior to epidural block, but paravertebral block did reduce the duration of hospital stay and provided better haemodynamic stability. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Romanian Journal of Anaesthesia and Intensive Care de Gruyter

Comparative study between ultrasound-guided lumbar paravertebral block and lumbar epidural block with ropivacaine for postoperative pain relief in patient undergoing total hip replacement surgery: A prospective randomised, double-blind study

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References (10)

Publisher
de Gruyter
Copyright
© 2021 Kavita Meena et al., published by Sciendo
eISSN
2502-0307
DOI
10.2478/rjaic-2021-0013
Publisher site
See Article on Publisher Site

Abstract

AbstractBackgroundTotal hip replacement (THR) is mostly performed in patients above 65 years of age. Patients of this age group typically have comorbidities, therefore safe techniques for anaesthesia and analgesia with minimal side effects should be chosen and should allow early mobilisation. Lumbar paravertebral block is less explored in this domain. The primary objective of this study is to compare the efficacy of ultrasound-guided lumbar paravertebral and epidural block using ropivacaine (0.25%) with fentanyl as adjuvant for postoperative pain in patients undergoing unilateral THR.Settings and DesignRandomised, controlled, double-blind, prospective study carried out in the Department of Anaesthesiology at Banaras Hindu University.Methods and MaterialAfter receiving institutional ethical committee clearance and written informed consent from patients, this study was carried out from February 2019 to February 2020. Sixty adult patients who required THR and fulfilled the inclusion criteria were randomised into two groups. The thirty patients in Group A received a continuous infusion of 5 ml/hr (0.25%) ropivacaine + 2 mcg/ml fentanyl via lumbar epidural catheter. The thirty patients in Group B received a continuous infusion of 5 ml/hr (0.25%) ropivacaine + 2 mcg/ml fentanyl via lumbar paravertebral catheter. Visual analogue scale (VAS) was used to evaluate pain scores. Rescue analgesia use and duration of hospital stay was calculated and compared in postoperative period. The statistical analysis of data was done by using software Statistical Package for Social Sciences SPSS for Windows (Version 23.0), and chi-square test was used for categorical variables. To compare the two groups of mean Student’s t-test and for more than two groups one-way analysis of variance, the ANOVA test was used.ResultsIn Group A, 16.7% patients required rescue analgesic, and in Group B, 26.7% required rescue analgesia which is comparable and non-significant. The mean duration of hospital stay in Group A is 7.50 days. Compared to 6.47 days in Group B, this difference is statistically significant (p-0.000).ConclusionsAnalgesia provided by paravertebral block is not superior to epidural block, but paravertebral block did reduce the duration of hospital stay and provided better haemodynamic stability.

Journal

Romanian Journal of Anaesthesia and Intensive Care – de Gruyter

Published: Dec 1, 2021

Keywords: analgesia; arthroplasty hip replacement epidural; ropivacaine; visual analogue scale

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