Blood rheology in PCA and PCEA after total knee arthroplasty.
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.
Beilin
Benzion
B
Department of Anaesthesiology, Rabin Medical Center, Golda Campus, Hasharon, Petah Tiqva, Israel.
Mayburd
Eduard
E
Yardeni
Israel-Zeev
IZ
Hendel
David
D
Robinson
Dror
D
Bessler
Hanna
H
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*