The preoperative analgesic effect of 3-in-1 block on postoperative pain and tramadol consumption in total hip arthroplasty.

医学 曲马多 麻醉 止痛药 芬太尼 关节置换术 外科 患者满意度 全髋关节置换术 术后疼痛
作者
Süleyman Köroğlu,Suna Akın Takmaz,Çetin Kaymak,Altuğ Narli,Kubilay Karalezli,Bayazıt Dikmen
出处
期刊:The journal of the Turkish Society of Algology 卷期号:20 (1): 19-25 被引量:10
标识
摘要

We studied the effect of preoperative 3-in-1 block for total hip replacement surgery on postoperative pain and tramadol consumption during patient-controlled analgesia. Thirty ASA I-II patients undergoing elective total hip arthroplasty (THA) were included in the study. Patients were randomly divided into 2 groups; Group I: Patients who received 3-in-1 block with 40 ml of 0.25% bupivacaine 30-minutes before surgery and later received general anesthesia, Group II: Patients who received only a simple needle puncture at the operation site 30-minutes before surgery and later received general anesthesia. All patients received intravenous tramadol at the end of surgery via a PCA device. Pain was evaluated at 0,1/2,1,4,8,12,24 and 48 h at rest and on movement of the hip, using a 10 cm VAS. The average intraoperative fentanyl consumption was lower in Group I than in Group II. VAS scores were significantly lower in group I, both at rest and during movement at all timepoints over in the first postoperative 12 h and also during movement 24 h postoperatively. However differences in VAS scores weren't clinically significant after 4 hours. In the recovery room, Group I VAS scores were only a third of Group II, both at rest and movement (p=0.0001). Total tramadol consumption was lower in Group I (633.0+/-119.3 mg) than in Group II (991.1+/-41.0 mg). Patient satisfaction scores were higher in Group I than in Group II. We concluded that preoperative 3-in-1 block with 40 ml-0,25% bupivacaine provides effective postoperative pain relief for elective THA, reducing intra-and postoperative analgesic consumption without increase in side effects.

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