Analgesia After Total Hip Arthroplasty: Peri-Articular Injection Versus Epidural Patient Controlled Analgesia (PCA)
| Status: | Recruiting |
|---|---|
| Conditions: | Arthritis, Osteoarthritis (OA) |
| Therapuetic Areas: | Rheumatology |
| Healthy: | No |
| Age Range: | 50 - 80 |
| Updated: | 4/2/2016 |
| Start Date: | February 2012 |
| Contact: | Shane C Reid, MS |
| Email: | reids@hss.edu |
| Phone: | 6467978536 |
Analgesia After Total Hip Arthroplasty: Peri-Articular Injection Versus Epidural Patient Controlled Analgesia
The best way to provide analgesia after total hip arthroplasty is hotly debated. There are
two protocols in use at Hospital for Special Surgery(HSS). Both protocols have their
proponents, but there are limited data for making an informed choice of protocols. For total
hip arthroplasty at HSS, epidural analgesia is used most frequently as it reduces pain with
physical therapy. However, epidural analgesia can be associated with nausea, pruritis,
dizziness, and orthostatic hypotension. These side-effects can slow physical therapy and may
prolong the time until the patient is ready for discharge. Some surgeons at HSS have decided
to use a different analgesic protocol, based on a peri-articular injection. This protocol
avoids epidural analgesia and systemic opioids. However, patients are given oral opioids as
part of a multimodal pain therapy. The investigators propose to compare peri-articular
injection to epidural patient controlled analgesia (Epidural PCA). The investigators will
enroll 90 total patients (45 per study arm). The enrollment period will be approximately one
year and the duration of the follow-up with study patients will be three months following
their procedure.
two protocols in use at Hospital for Special Surgery(HSS). Both protocols have their
proponents, but there are limited data for making an informed choice of protocols. For total
hip arthroplasty at HSS, epidural analgesia is used most frequently as it reduces pain with
physical therapy. However, epidural analgesia can be associated with nausea, pruritis,
dizziness, and orthostatic hypotension. These side-effects can slow physical therapy and may
prolong the time until the patient is ready for discharge. Some surgeons at HSS have decided
to use a different analgesic protocol, based on a peri-articular injection. This protocol
avoids epidural analgesia and systemic opioids. However, patients are given oral opioids as
part of a multimodal pain therapy. The investigators propose to compare peri-articular
injection to epidural patient controlled analgesia (Epidural PCA). The investigators will
enroll 90 total patients (45 per study arm). The enrollment period will be approximately one
year and the duration of the follow-up with study patients will be three months following
their procedure.
Inclusion Criteria:
- Patients with osteoarthritis scheduled for primary total hip arthroplasty with a
participating surgeon
- Age 50 to 80 years old
- Planned use of regional anesthesia
- Ability to follow study protocol
Exclusion Criteria:
- Patients younger than 50 years old and older than 80
- Patients intending to receive general anesthesia
- Allergy or intolerance to one of the study medications
- Patients with an ASA of IV
- Patients with insulin-dependent diabetes
- Patients with hepatic (liver) failure
- Patients with chronic renal (kidney) failure
- Chronic opioid use (taking opioids for longer than 3 months)
- Patients with any prior major ipsilateral hip surgery
- Allergy to any of the medications (or adhesives) involved in the protocol
We found this trial at
1
site
Hospital for Special Surgery Founded in 1863, Hospital for Special Surgery is the nation
Click here to add this to my saved trials
