title: Caudal epidural anesthesia administered intraoperatively provides for effective postoperative analgesia after total hip arthroplasty.
abstract: OBJECTIVE
  To investigate the use of caudal epidural anesthesia for postoperative pain after total hip arthroplasty.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University-affiliated hospital.
  
  
  METHODS
  32 (4 men and 28 women) patients, aged 49 to 89 years, scheduled for total hip arthroplasty for osteoarthritis of the hip.
  
  
  METHODS
  Patients were allocated to three groups: lumbar epidural anesthesia (EA group; n = 16) or caudal epidural anesthesia (CA group; n = 16) groups, which were case-matched according to patient demographics. Nine patients received general anesthesia only (GA group). We evaluated the level of postoperative pain using a 100-mm Visual Analog Scale (VAS) recorded at 3, 6, 9, 12, and 24 hours after surgery.
  
  
  RESULTS
  Total requirement of diclofenac sodium suppositories was significantly larger in the GA group than in the EA or CA groups (444 +/- 302 vs 188 +/- 124 and 145 +/- 130 mg). The number of days requiring analgesics was significantly prolonged in the GA group compared with the EA or CA groups (14 +/- 9 vs 4 +/- 3 and 4 +/- 4 days). These items were similar between the EA group and the CA group. All VAS values for pain, rest, and movement in the postsurgical period over 24 hours were significantly higher in the GA group than in either the EA or CA groups.
  
  
  CONCLUSIONS
  Caudal epidural anesthesia provides effective postoperative analgesia similar to lumbar epidural anesthesia.
authors.affiliation: Department of Anesthesiology, Osaka Police Hospital, Tennoji, Osaka 543-8502, Japan. tkita@cvn.bai.ne.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Kita
authors.forename: Naritoshi
authors.initials: N
authors.lastname: Maki
authors.forename: Yong Su
authors.initials: YS
authors.lastname: Song
authors.forename: Fumio
authors.initials: F
authors.lastname: Arai
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Nakai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000763:Anesthesia, Caudal / Q000379:methods; D000767:Anesthesia, Epidural / Q000379:methods*; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D018709:Statistics, Nonparametric