Comparative study between ultrasound-guided lumbar paravertebral block and lumbar epidural block with ropivacaine for postoperative pain relief in patient undergoing total hip replacement surgery: A prospective randomised, double-blind study
Article Category: Original Paper
Published Online: Dec 29, 2022
Page range: 80 - 85
DOI: https://doi.org/10.2478/rjaic-2021-0013
Keywords
© 2021 Kavita Meena et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Background
Total hip replacement (THR) is mostly performed in patients above 65 years of age. Patients of this age group typically have comorbidities, therefore safe techniques for anaesthesia and analgesia with minimal side effects should be chosen and should allow early mobilisation. Lumbar paravertebral block is less explored in this domain. The primary objective of this study is to compare the efficacy of ultrasound-guided lumbar paravertebral and epidural block using ropivacaine (0.25%) with fentanyl as adjuvant for postoperative pain in patients undergoing unilateral THR.
Settings and Design
Randomised, controlled, double-blind, prospective study carried out in the Department of Anaesthesiology at Banaras Hindu University.
Methods and Material
After receiving institutional ethical committee clearance and written informed consent from patients, this study was carried out from February 2019 to February 2020. Sixty adult patients who required THR and fulfilled the inclusion criteria were randomised into two groups. The thirty patients in Group A received a continuous infusion of 5 ml/hr (0.25%) ropivacaine + 2 mcg/ml fentanyl via lumbar epidural catheter. The thirty patients in Group B received a continuous infusion of 5 ml/hr (0.25%) ropivacaine + 2 mcg/ml fentanyl via lumbar paravertebral catheter. Visual analogue scale (VAS) was used to evaluate pain scores. Rescue analgesia use and duration of hospital stay was calculated and compared in postoperative period. The statistical analysis of data was done by using software Statistical Package for Social Sciences SPSS for Windows (Version 23.0), and chi-square test was used for categorical variables. To compare the two groups of mean Student’s t-test and for more than two groups one-way analysis of variance, the ANOVA test was used.
Results
In Group A, 16.7% patients required rescue analgesic, and in Group B, 26.7% required rescue analgesia which is comparable and non-significant. The mean duration of hospital stay in Group A is 7.50 days. Compared to 6.47 days in Group B, this difference is statistically significant (p-0.000).
Conclusions
Analgesia provided by paravertebral block is not superior to epidural block, but paravertebral block did reduce the duration of hospital stay and provided better haemodynamic stability.