Analgesia after total hip replacement : epidural versus psoas compartment block

dc.contributor.advisorSmith, Francois Jacobusen
dc.contributor.emailjc_bosch@yahoo.comen
dc.contributor.postgraduateBosch, Johannes Coenraad
dc.date.accessioned2013-09-09T07:22:59Z
dc.date.available2006-08-03en
dc.date.available2013-09-09T07:22:59Z
dc.date.created2005-12-31en
dc.date.issued2005-10en
dc.date.submitted2006-01-12en
dc.descriptionDissertation (MMed (Anaesthesiology))--University of Pretoria, 2005.en
dc.description.abstractIntroduction Both epidural anaesthesia and psoas compartment block have been advocated for analgesia after hip replacement. The aim of this study was to evaluate the effectiveness of a psoas compartment block, as compared to an epidural, for postoperative analgesia following total hip replacement surgery. Method Patients scheduled for total hip replacement surgery were randomly allocated to one of two groups, one group receiving an epidural, and the other a psoas compartment block preoperatively. An infusion of bupivacaine 0.167% was continued postoperatively for 24h. Postoperative pain was assessed at 0, 1, 4, 8 and 24 hours using the visual analogue pain score (VAPS). The amount of local anaesthesia, need for additional morphine, as well as any side effects, was recorded. Results Thirty-six patients completed the study, 18 in each group. There was no significant difference between the two groups regarding VAPS at the different times (p = 0.4246), but local anaesthetic and opiate consumption was significantly higher in the psoas compartment block group. Postoperative morphine as co-variate had a significant influence on the mean postoperative VAPS (p = 0.0066). There was no significant difference between the number of side effects in each group (p = 0.3377). Conclusion Epidural analgesia was more effective than the psoas compartment block after hip replacement surgery. Although pain did not differ significantly, local anaesthetic and opiate consumption was significantly higher in the psoas compartment group.en
dc.description.availabilityRestricteden
dc.description.degreeMMed (Anaesthesiology)
dc.description.departmentAnaesthesiologyen
dc.description.facultyHealth Sciencesen
dc.identifier.citationBosch, J 2005, Analgesia after total hip replacement : epidural versus psoas compartment block, MMed(Anaesthesiology) dissertation, University of Pretoria, Pretoria, viewed yymmdd < http://upetd.up.ac.za/thesis/available/etd-01122006-183711/ >en
dc.identifier.upetdurlhttp://upetd.up.ac.za/thesis/available/etd-01122006-183711/en
dc.identifier.urihttp://hdl.handle.net/2263/30654
dc.language.isoenen
dc.publisherUniversity of Pretoria
dc.rights© 2005, University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria.en
dc.subjectUCTDen
dc.subjectPost-operative analgesiaen
dc.subjectHip replacement surgeryen
dc.subjectEpiduralen
dc.subjectPsoas compartment block
dc.titleAnalgesia after total hip replacement : epidural versus psoas compartment blocken
dc.typeDissertationen

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