Total Hip Arthroplasty Outcomes With Regional and Multimodal Analgesia (THA)

Medical University of South Carolina (MUSC)

Status: Completed

Conditions: Replacement, Hip; Arthroplasty; Arthritis

Study type: Observational

Funder types: Other

Identifiers

NCT02186795

THA Retrospective Analysis

Details and patient eligibility

About

The goal of this retrospective chart review is to evaluate if the implementation of lumbar plexus block placement for postoperative pain and administration of multimodal oral analgesia have improved conditions in the postoperative period for patients undergoing total hip arthroplasty when compared to the placement of epidurals for postoperative pain management.

Full description

Primary outcome: 48 hour opiate consumption in patients following THA. ' Secondary outcome: Time to first ambulation, assitstance needed with ambulation, opiate and regional related side effects, time to discharge orders.

Enrollment: 117 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

1. Primary total hip arthroplasty, (identified by current procedural terminology (CPT) code 27130) and

2. Either a) Epidural or b) Lumbar plexus peripheral nerve block with the administration of multimodal medication after July 2012.

   Exclusion Criteria:Exclusion criteria include THA Revision, ICU admission postoperatively, and dementia, not allowing pain score communication.

Trial design

117 participants in 2 patient groups

Lumbar plexus

Description:

Patients received a preoperative lumbar plexus nerve block (20 ml, ropivacaine 0.5%) for postoperative pain management with one to four multimodal oral pain medications (acetaminophen, celecoxib, oxycodone ER, gabapentin, pregabalin) administered preoperatively or in the first 48 hours postoperatively.

Lumbar Epidural

Description:

Patients received a lumbar epidural preoperatively for postoperative pain management. Epidural infusions of ropivacaine 0.2% were initiated intraoperatively, administered until the morning of postoperative day 1, and titrated to patient comfort.