title: Blood rheology in PCA and PCEA after total knee arthroplasty.
abstract: The rheological events in 2 groups of patients undergoing total knee arthroplasty were compared--15 patients were given general anesthesia and controlled their postoperative pain applying intravenous patient-controlled analgesia; 17 individuals received combined spinal-epidural anesthesia and controlled their postoperative pain by patient-controlled epidural analgesia (PCEA). Twenty-four and 48 hours after surgery, the patient-controlled analgesia group showed a significant increase in whole-blood viscosity at the 3 shear rates (P < .01), as well as in relative viscosity at both periods (P < .001 and .01, respectively). Similar findings were observed for red blood cell aggregation (P < .001) and fibrinogen level (P < .001). These values were less expressed in the PCEA group, particularly 48 hours after surgery (P < .01), and the patients showed lower scores on the visual analog pain scale. The better results observed in the PCEA group favor the application of epidural anesthesia and PCEA analgesia in patients undergoing total knee arthroplasty.
authors.affiliation: Department of Anaesthesiology, Rabin Medical Center, Golda Campus, Hasharon, Petah Tiqva, Israel.
authors.forename: Benzion
authors.initials: B
authors.lastname: Beilin
authors.forename: Eduard
authors.initials: E
authors.lastname: Mayburd
authors.forename: Israel-Zeev
authors.initials: IZ
authors.lastname: Yardeni
authors.forename: David
authors.initials: D
authors.lastname: Hendel
authors.forename: Dror
authors.initials: D
authors.lastname: Robinson
authors.forename: Hanna
authors.initials: H
authors.lastname: Bessler
mesh_terms: D000368:Aged; D016058:Analgesia, Patient-Controlled; D000767:Anesthesia, Epidural / Q000379:methods*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D018056:Hemorheology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology / Q000628:therapy*