Novosti
Khirurgii
This journal is
indexed in Scopus



Year 2018 Vol. 26 No 3

TRAUMATOLOGY & ORTHOPEDICS

DOI: https://dx.doi.org/10.18484/2305-0047.2018.3.332   |  

G.P. KOTELNIKOV, YU.V. LARTSEV, I.G. TRUKHANOVA, A.D. GUREEV, O.V. FIRSTOVA, D.S. KUDASHEV

POSTOPERATIVE PROLONGED INFILTRATION ANESTHESIA FOR MMULTIMODAL PERIOPERATIVE PAIN MANAGEMENT IN PATIENTS WITH HIP REPLACEMENT ARTHROPLASTY

Samara State Medical University, Samara,
The Russian Federation

Objective. To improve the efficiency of multimodal perioperative pain management in patients in case of the hip replacement arthroplasty using postoperative prolonged infiltration anesthesia in the area of surgical intervention.
Methods. A prospective comparative analysis of the treatment results of 78 patients underwent the primary hip replacement arthroplasty was performed. The patients were divided into two groups: (1) the first group of patients was treated with prolonged epidural analgesia in the postoperative period, while (2) in the second group, the patients were treated with prolonged 24-hour infiltration anesthesia at the area of the surgical intervention by 0.2% of the ropivacaine hydrochloride solution, administered using microinfusion pump with a constant rate of 8 ml per hour. All patients were assessed for intensity of the pain syndrome, plasma concentrations of the cortisol and blood glucose levels. Also, trimeperidine consumption rate and the start of patients activity were assessed. The evaluation was conducted 24 hours prior to the surgical intervention, as well as 6 and 24 hours after.
Results. 24 hours after the surgery, the pain intensity scores assessed by the VAS were 2.20.35 and 1.50.42 points in the first and second clinical groups, respectively; the cortisol plasma levels 24 hours after the surgical intervention were 768.545.8 nmol/l and 584.654.2 nmol/l in the first and second clinical groups, respectively; the blood glucose levels after the surgical intervention were 7.030.34 mmol/l and 5.910.27 mmol/l in the first and second clinical groups, respectively. Trimeperidine consumption rates for the first 24 hours after the surgical intervention were 38.62.95 mg and 21.33.17 mg in the first and second clinical groups, respectively. The first sitting and complete verticalization of patients in the first group were performed in 24.82.4 and 281.4 hours, while in the second clinical group, these activities were performed in 4.50.5 and 6.30.7 hours respectively.
Conclusions. The use of the prolonged infiltration anesthesia allowed by 46.7% more effectively arresting pain syndrome, by 55.2% reducing trimeperidine consumption rate for the first 24 hours after the surgical intervention and by 20.31.4 hours earlier starting activation of patients if compared to the prolonged epidural analgesia.

Keywords: hip replacement arthroplasty, epidural anesthesia, infiltration anesthesia, ropivacaine hydrochloride, microinfusion pump
p. 332-339 of the original issue
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Address for correspondence:
443099, The Russian Federation,
Samara, Chapayevskaya Str., 89,
Samara State Medical University,
Department of Traumatology,
Orthopedics and Extreme Surgery
named after Acad. of RAS A.F. Krasnov,
Tel.: +79276076209,
e-mail: dr.kudashev@gmail.com,
dmitrykudashew@mail.ru,
Dmitrij S. Kudashev
Information about the authors:
Kotelnikov Gennady P., Academician of RAS, MD, Professor, Head of the Department of Traumatology, Orthopedics and Extreme Surgery named after Acad. of RAS A.F. Krasnov, Samara State Medical University, Samara, Russian Federation.
https://orcid.org/0000-0001-7456-6160
Lartsev Yuri V., MD, Head of the Traumatology and Orthopedics unit 2 of Clinic of Samara State Medical University, Professor of the Department of Traumatology, Orthopedics and Extreme Surgery named after Acad. of RAS A.F. Krasnov, Samara State Medical University, Samara, Russian Federation.
https://orcid.org/0000-0003-4450-2486
Trukhanova Inna G., MD, Head of the Department of Anesthesiology, Reanimatology and Emergency Medical Care of the Institute of Vocational Education, Samara State Medical University, Samara, Russian Federation.
https://orcid.org/0000-0002-2191-1087
Gureev Anton D., Head of the Anaesthesiology-Resuscitation Unit of Clinic of Samara State Medical University, Assistant of the Department of Anesthesiology, Reanimatology and Emergency Medical Care of the Institute of Vocational Education, Samara State Medical University, Samara, Russian Federation.
https://orcid.org/0000-0001-8389-7244
Firstova Olga V., Anesthetist-Resuscitator of the Anaesthesiology-Resuscitation Unit of Clinic of Samara State Medical University, Samara, Russian Federation.
https://orcid.org/0000-0002-8920-0433
Kudashev Dmitrij S., MD, Traumatologist-Orthopedist of the Traumatology and Orthopedics unit 2 of Clinics of Samara State Medical University, Assistant of the Department of Traumatology, Orthopedics and Extreme Surgery named after Acad. of RAS A.F. Krasnov, Samara State Medical University, Samara, Russian Federation.
https://orcid.org/0000-0001-8002-7294
Contacts | ©Vitebsk State Medical University, 2007