title: THE USE OF PARAVERTEBRAL BLOCKADE FOR ANALGESIA AFTER ANTERIOR-APPROACH TOTAL HIP ARTHROPLASTY.
abstract: BACKGROUND
  Anterior approaches for total hip arthroplasty (ATHA) are becoming increasingly popular. We postulated that the use of PVB of the T12, L1, and L2 roots would provide adequate analgesia for ATHA while allowing motor sparing.
  
  
  METHODS
  The medical records of 20 patients undergoing primary ATHA were reviewed. T12, L1 and L2 paravertebral blockade was accomplished with 3-4 ml of 1% ropivacaine with epinephrine 1:200,000 and 0.5 mg/ml of preservative-free dexamethasone per level. Primary outcomes were mean opioid consumption in intravenous morphine equivalents and worst recorded visual analog scale (VAS) pain scores during postoperative days 0 to 2 (POD 0 to 2).
  
  
  RESULTS
  Mean opioid consumption was 8.4 mg on POD0, 16.6 mg on POD1, and 9.8 mg on POD2. Median worst VAS scores were 2 for all time intervals except POD 0, which had a median value of 0. All patients had full hip motor strength the evening of POD0.19 patients were able to ambulate the afternoon of POD1.
  
  
  CONCLUSIONS
  T12-L2 PVB, when utilized as part of a multimodal analgesic regimen, results in moderate opioid consumption, low VAS scores, preservation of hip motor function, and may be an effective regional anesthesia technique for ATHA.
authors.forename: Alberto E
authors.initials: AE
authors.lastname: Ardon
authors.forename: Roy A
authors.initials: RA
authors.lastname: Greengrass
authors.forename: Upasna
authors.initials: U
authors.lastname: Bhuria
authors.forename: Steven B
authors.initials: SB
authors.lastname: Porter
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Robards
authors.forename: Kurt
authors.initials: K
authors.lastname: Blasser
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000628:therapy*; D064232:Visual Analog Scale
chemical_list: D000701:Analgesics, Opioid