[The effects of two different multimodal analgesic regimens in total hip replacement surgery].
OBJECTIVE
This study evaluated the effectiveness of two different multimodal analgesia protocols in terms of postoperative pain relief, tramadol consumption during patient-controlled analgesia (PCA) and side effects after total hip replacement surgery.


METHODS
Group F (n=18) received general anesthesia after a 3-in-1 femoral nerve block (FNB) was applied using 40 ml of bupivacaine 0.25%. Group FD (n=18) received general anesthesia after the same block and dexketoprofen p.o. was given. All patients received intravenous tramadol at the end of surgery via a PCA device. Group FD was given dexketoprofen 75 mg/day for 48 hours postoperatively. Pain scores were evaluated at 0, 1/2, 1, 4, 8, 12, 24 and 48h at rest and on movement of the hip. Side effects and global satisfaction scores in both groups were also evaluated in this setting.


RESULTS
Total tramadol consumption was lower in Group FD (377.7+/-137.4) than in Group F (593.9+/-132.3) (p<0.05). Visual analogue scale (VAS) scores were </=3 in all follow-up periods in both groups. While in Group FD, 6 patients had nausea, 3 vomiting and 1 sedation, in Group F, 5 patients had nausea, 3 vomiting and 2 sedation. Patient global satisfaction scores in Group F were very good in 14 patients and good in 4 patients, and in Group FD were very good in 13 patients and good in 5 patients.


CONCLUSIONS
Both analgesia protocols were effective in pain relief in total hip replacement patients, with similar side effects. The effect of additional dexketoprofen was to reduce postoperative tramadol consumption.
Inan
Nurten
N
2nd Department of Anesthesiology and Reanimation, Ankara Training and Research Hospital, Ankara, Turkey. nurteninan@yahoo.com
Akin Takmaz
Suna
S
Iltar
Serkan
S
Yazici
Işin
I
Başar
Hülya
H
D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000768:Anesthesia, General; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005267:Femoral Nerve / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D014147:Tramadol / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use
D000701:Analgesics, Opioid; D014147:Tramadol