Local infiltration analgesia with levobupivacaine compared with intrathecal morphine in total hip arthroplasty patients
Acta Anaesthesiologica Scandinavica,  Clinical Article

Rikalainen–Salmi R et al. – While local infiltration analgesia (LIA) might enable earlier mobilization after total hip arthroplasty (THA), it was not associated with less nausea as compared with intrathecal morphine (it–M). Less rescue oxycodone was given early after it–M, but urinary retention was more common in that group.

Methods
  • This randomized controlled trial comprised 60 patients undergoing THA under spinal anaesthesia.
  • For LIA, the surgeon administered levobupivacaine, ketorolac and epinephrine at the surgical site intraoperatively.
  • LIA patients received a LIA top-up through a wound catheter on the morning of the 1st post-operative day (POD).
  • In group it-M, 0.1mg morphine was given together with the spinal anaesthetic.
  • Study parameters included pain scores, vital parameters and side effects, e.g., post-operative nausea and vomiting (PONV).
  • Besides, levobupivacaine plasma concentrations were determined in 10 LIA patients.

Results
  • The median (25th/75th percentiles) rescue oxycodone demand differed significantly with LIA 15 (10/25)mg vs. 8.5 (1.5/15)mg with it-M (P <0.006) during the day of surgery, but not anymore on 1st or 2nd POD.
  • The LIA top-up had no effect.
  • However, both analgesic regimens resulted in comparable pain scores and patient satisfaction.
  • PONV incidence and medication did not vary significantly.
  • LIA offered certain advantages regarding early post-operative mobilization.
  • Maximum levobupivacaine plasma concentrations (229-580ng/ml) remained under the toxic level.

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Anesthesiology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

<

Most Popular Anesthesiology Articles

1 Should we induce general anesthesia in the prone position? Current Opinion in Anesthesiology, November 19, 2014    Review Article

2 Efficacy of a single dose of dexmedetomidine for cough suppression during anesthetic emergence: A randomized controlled trial Canadian Journal of Anesthesia, December 22, 2014    Clinical Article

3 Effects of steep Trendelenburg position for robotic-assisted prostatectomies on intra- and extrathoracic airways in patients with or without chronic obstructive pulmonary disease British Journal of Anesthesia, December 16, 2014    Clinical Article

4 A nomogram for calculating the maximum dose of local anaesthetic Anaesthesia, May 13, 2014    Clinical Article

5 Type of anaesthesia and patient quality of recovery: A randomized trial comparing propofol–remifentanil total i.v. anaesthesia with desflurane anaesthesia British Journal of Anesthesia, December 15, 2014    Clinical Article

6 Sugammadex versus neostigmine in pediatric patients: A prospective randomized study Full Text Revista Brasileira de Anestesiologia, December 3, 2014    Free full text    Clinical Article

7 Comparison of vestipitant with ondansetron for the treatment of breakthrough postoperative nausea and vomiting after failed prophylaxis with ondansetron British Journal of Anesthesia, December 10, 2014    Clinical Article

8 Major incidents and complications in otherwise healthy patients undergoing elective procedures: Results based on 1.36 million anaesthetic procedures British Journal of Anesthesia, May 9, 2014    Review Article

9 Commonly prescribed drug for lower back pain not effective University of Rochester Medical Center, December 12, 2014

10 Comparison of analgesic efficacy of paracetamol and tramadol for pain relief in active labor Journal of Clinical Anesthesia, December 4, 2014    Clinical Article

11 Cranial nerve injuries with supraglottic airway devices: A systematic review of published case reports and series Anaesthesia, November 12, 2014    Evidence Based Medicine

12 The effect of different doses of esmolol on hemodynamic, bispectral index and movement response during orotracheal intubation: Prospective, randomized, double-blind study Full Text Revista Brasileira de Anestesiologia, December 1, 2014    Free full text    Clinical Article

13 Oral administration of morphine versus ibuprofen to manage postfracture pain in children: a randomized trial Canadian Medical Association Journal, December 11, 2014    Evidence Based Medicine    Clinical Article

14 The effect of ketamine on hypoventilation during deep sedation with midazolam and propofol: A randomised, double-blind, placebo-controlled trial European Journal of Anaesthesiology, November 14, 2014    Clinical Article

15 The intubation scoop (i-scoop) - A new type of laryngoscope for difficult and normal airways Anaesthesia, June 12, 2014    Clinical Article

16 Comparison of different tests to determine difficult intubation in pediatric patients Full Text Revista Brasileira de Anestesiologia, December 2, 2014    Free full text    Clinical Article

17 Pharmacologic agents for the prevention and treatment of delirium in patients undergoing cardiac surgery: Systematic review and metaanalysis Critical Care Medicine, December 24, 2014    Evidence Based Medicine

18 Forearm bier block: a new regional anesthetic technique for upper extremity surgery Annals of Plastic Surgery, August 8, 2014    Review Article

19 New hope for patients with Complex Regional Pain Syndrome University of Liverpool News, December 8, 2014

20 Comparison of early and late percutaneous tracheotomies in adult intensive care unit Full Text Revista Brasileira de Anestesiologia, December 8, 2014    Free full text    Clinical Article

Indexed Journals in Anesthesiology: Anaesthesia, Anesthesia & Analgesia, Current Anaesthesia and Critical Caremore

Make smarter career moves with less time.

Sign up for our free job placement service today and have a dedicated career consultant help locate the right physician job for you!
Click Here for more information.

Get Started Now!

Free-of-charge, no obligation.

Terms and Conditions For M3 Career Consult

By registering with the M3 Career Consult service you authorize M3 USA Corporation to represent you in your job search. The following is a summary of the terms of our service and our mutual obligations to help you find a job:

  • You designate M3 to act as your agent and represent you in your job search;
  • You will not pay us for this service
  • You will advise us of any companies or positions to which you apply or have applied;
  • You will advise us if you believe you are not capable of performing a position for which we submit you, or for which you interview;
  • You will keep all information we provide you about companies or positions strictly confidential;
  • You will promptly provide us with information we request of you;
  • You will make yourself reasonably available for phone, video and in-person conversations and interviews;
  • You will be truthful in all of your communications with us; and
  • You will advise us if anything above changes.
 

The Top Read Articles of 2014 are Now Available

Scouring thousands of peer-reviewed journals and popular press, Our Editors just released the Top Read Articles of the Year. See the Top Read List