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• W2024984764 abstract "S262 CB is effective to relieve pain after THR. [1] Its influence on blood losses after hip surgery has not been studied. Epidural anesthesia significantly reduces intraoperative blood losses after THR. [2] The aim of this study was to compare the effects of CB, EA and IV PCA on perioperative blood losses and blood requirements after elective THR. METHODS: After informed consent and institutional approval, 45 ASA class 1-3 patients scheduled for elective THR under general anesthesia were included in this study. They were randomly divided into three groups of 15. They received no block in group A, CB prior surgery in group B and EA in group C. CB was performed following Winnie's landmarks. [3] A 20G catheter was threaded 10-15 cm into the psoas compartment and 40 ml 0.25% bupivacaine with epinephrine 1/200000 were injected and followed by a continuous infusion of 0.125% bupivacaine at 10 ml/hour during 48 hours. EA was performed at L2-L3 or L3-L4 level. A 18G catheter was threaded 4-5 cm into the epidural space and 10 ml 0.25% bupivacaine with epinephrine 1/200000 and 10 [micro sign]g sufentanil were injected and followed by the same continuous infusion. In group A, postoperative analgesia was administered by IV PCA with morphine. During the procedure, mean blood pressure (BP) was maintained > 65 mm Hg with ephedrine. Hb level was maintained > 8 g/dl during the hospital stay. Studied variables were: intraoperative hemodynamics, Hb level preoperatively and at discharge from the hospital, measurable perioperative blood losses (suction, sponges, redons) and blood requirements. Statistical analysis was done with ANOVA and LSD test when appropriated. Results are expressed as means +/- SEM. A p value < 0.05 was considered significant. RESULTS: Population data, duration of surgery, and intraoperative hemodynamics were comparable in all groups. However, a significantly higher dose of ephedrine was required in group C (8.3 +/- 2.3 mg) when compared with groups A (1 +/- 0.6 mg) and B (2.3 +/- 1 mg) to maintain mean BP > 65 mm Hg. Other studied variables are presented in Table 1. No significant difference was noted between the groups.Table 1CONCLUSIONS: In elective THR, CB and normotensive (mean BP > 65 mm Hg) EA have no effect on total blood losses and homologous blood requirement." @default.
• W2024984764 created "2016-06-24" @default.
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• W2024984764 date "1998-02-01" @default.
• W2024984764 modified "2023-09-27" @default.
• W2024984764 title "PERIOPERATIVE BLOOD LOSSES AFTER TOTAL HIP REPLACEMENT (THR)" @default.
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• W2024984764 doi "https://doi.org/10.1097/00000539-199802001-00260" @default.
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