Comparison of general anesthesia with and without lumbar epidural for total hip arthroplasty: Effects of epidural block on hip arthroplasty
| Autor: | H. D. Fuller, Eric Stanton, Karen Raymer, Alezandre Dauphin |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Anesthesia
Epidural Male medicine.medical_specialty medicine.drug_class Blood Loss Surgical Anesthesia General law.invention Postoperative Complications Lumbar Double-Blind Method Randomized controlled trial law Monitoring Intraoperative medicine Humans Plethysmograph Aged Bupivacaine business.industry Hemodynamics Muscle relaxant Perioperative Surgery Anesthesiology and Pain Medicine Isoflurane Anesthesia Anesthetic Female Hip Prosthesis business medicine.drug |
| Zdroj: | Journal of Clinical Anesthesia. 9:200-203 |
| ISSN: | 0952-8180 |
| DOI: | 10.1016/s0952-8180(97)00035-4 |
| Popis: | To determine whether lumbar epidural anesthesia, when combined with general anesthesia, decreases perioperative blood loss, the incidence of postoperative deep vein thrombosis (DVT), cardiac dysrhythmias, and ischemia in patients undergoing total hip arthroplasty (THA).Randomized, controlled study.A university hospital.37 ASA physical status I, II, and III patients, undergoing elective THA.Patients were divided into two statistically comparable groups: Group GA = general anesthesia; Group CEGA = general anesthesia plus lumbar epidural anesthesia. All patients had 48-hour perioperative Holter monitoring, applied on admission, the day prior to surgery. In both groups, general anesthesia was induced with thiopental sodium and muscle relaxant, and maintained with oxygen, nitrous oxide, isoflurane, opioid, and muscle relaxant. Group B received lumbar epidural anesthesia with 10 ml 0.5% bupivacaine with 1:200,000 epinephrine prior to anesthesia induction. Blood loss was measured by suction bottle contents, sponge weights, and collection drainage. DVT was assessed with postoperative leg scanning, plethysmography, and venogram.Intraoperative blood loss was less after combined epidural-general anesthesia (663.8 ml +/- 299.0 ml) than after general anesthesia alone (1,259.2 ml +/- 366.0 ml). The difference was found to be statistically significant (p0.00005). No difference was found between the two groups in postoperative blood loss, incidence of DVT, cardiac dysrhythmias, or ischemia.Combined regional-general anesthesia decreases intraoperative blood loss in THA, and thereby offers an advantage over general anesthesia alone. |
| Databáze: | OpenAIRE |
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