[The effects of lumbar plexus block and epidural block on total blood loss and postoperative analgesia in total hip arthroplasty].
OBJECTIVE
In this study, the effects of lumbar plexus block and epidural block on total blood loss and postoperative analgesia in patients undergoing total hip arthroplasty (THA) under general anesthesia was documented.


METHODS
The study included 45 patients undergoing THA under general anesthesia. Group GA (n=15) received general anesthesia, Group GA+E (n=15) received general anesthesia + epidural catheter and Group GA+LPB (n=15) received general anesthesia + lumbar plexus catheterization. Intraoperative blood transfusion (IOBT) requirements and intraoperative bleeding (IOB) were documented. Postoperative hemoglobin, hematocrit and total blood loss through the drains were also documented. All patients received patient-controlled analgesia through the IV route. Time to first analgesic requirement (TFAR), total IV morphine consumption (MORPH 24) and 24-hour visual analogue scale (VAS) values were evaluated.


RESULTS
TFAR was the lowest (8.7+/-4.0 min.) in the GA group and highest (42.7+/-14.4 min) in the GA+LPB group, and the GA+E group had lower values than the GA+LPB (32.3+/-16.0 min) group (p<0.05). IOBT, IOB, and MORPH 24 average values were the lowest in the GA+LPB group and highest in the GA group, with GA+E in between (p<0.05). Postoperative first VAS values were significantly different between the GA group and the others (p<0.001). There was also a significant difference between the GA group and the others regarding postoperative average Hb values (p<0.02).


CONCLUSIONS
THA using either regional technique provides less blood loss and better analgesia. We will consider LPB in our future cases in view of the lower intraoperative blood loss and better analgesia.
Utebey
Gülten
G
2nd Department of Anesthesiology and Reanimation, Dişkapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Akkaya
Taylan
T
Alptekin
Alp
A
Sayin
Murat
M
Gümüş
Haluk
H
Ateş
Yalim
Y
D015360:Analgesia, Epidural; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000768:Anesthesia, General; D019644:Arthroplasty, Replacement, Hip; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008160:Lumbosacral Plexus; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use*; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D019106:Postoperative Hemorrhage / Q000517:prevention & control*
D000701:Analgesics, Opioid; D009020:Morphine