Comparison of general anesthesia with and without lumbar epidural for total hip arthroplasty: effects of epidural block on hip arthroplasty

Journal of Clinical Anesthesia
A DauphinH D Fuller

Abstract

To determine whether lumbar epidural anesthesia, when combined with general anesthesia, decreases perioperative blood loss, the incidence of postoperative deep vein thrombosis (DVT), cardiac dysrhythmias, and ischemia in patients undergoing total hip arthroplasty (THA). Randomized, controlled study. A university hospital. 37 ASA physical status I, II, and III patients, undergoing elective THA. Patients were divided into two statistically comparable groups: Group GA = general anesthesia; Group CEGA = general anesthesia plus lumbar epidural anesthesia. All patients had 48-hour perioperative Holter monitoring, applied on admission, the day prior to surgery. In both groups, general anesthesia was induced with thiopental sodium and muscle relaxant, and maintained with oxygen, nitrous oxide, isoflurane, opioid, and muscle relaxant. Group B received lumbar epidural anesthesia with 10 ml 0.5% bupivacaine with 1:200,000 epinephrine prior to anesthesia induction. Blood loss was measured by suction bottle contents, sponge weights, and collection drainage. DVT was assessed with postoperative leg scanning, plethysmography, and venogram. Intraoperative blood loss was less after combined epidural-general anesthesia (663.8 ml +/- 299.0 ml) tha...Continue Reading

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Citations

May 8, 2003·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Tadahisa FunayamaTeruo Kumazawa
Jun 17, 2009·Archives of Orthopaedic and Trauma Surgery·Wieger Geert HorstmannCees C P M Verheyen
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May 31, 2011·Anesthesiology Clinics·Dennis P PhillipsBrian A Williams
Apr 6, 2005·Journal of Clinical Anesthesia·Battista BorghiRenata Alleva
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Sep 15, 2021·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Daniel J CunninghamMark J Gage

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