Why the study?
With increasing demand for hip replacement in an ageing population, new approaches such as the Fast-track principle are needed to improve recovery and reduce hospital stay.
Does spinal anaesthesia with prilocaine and early rehabilitation reduce postoperative pain and hospital stay in patients undergoing total hip replacement compared to bupivacaine?
Does spinal anaesthesia with prilocaine and early rehabilitation reduce postoperative pain and hospital stay in patients undergoing total hip replacement compared to bupivacaine?
Fast-track surgery with intermediate-acting spinal anaesthesia (prilocaine) and early rehabilitation reduces postoperative pain and shortens hospital stay in total hip replacement patients.
Due to an ageing population, the necessity for hip replacement has grown, and therefore, new options are being sought, such as the Fast-track principle, to improve patient condition, reduce their hospital stay and enhance the hospital’s ability to treat more patients. The aim of this study was to investigate the effects of same-day patient mobilisation on pain, side effects, complications, duration of hospital stay, and recovery after primary hip replacement, using intermediate-acting local anaesthetics in spinal anaesthesia (SA). A prospective, randomised study was conducted at the Hospital of Traumatology and Orthopaedics. Forty-six patients undergoing total hip replacement were selected and divided into two groups. Spinal anaesthesia was performed in study group (P) with 70 mg plain prilocaine. The control group (B) received 18 mg heavy bupivacaine in SA. On the first postoperative day, pain during movement was 2.00 (P) and 3.33 (B) on the Numeric Pain Rating Scale, the duration of hospital stay in the study group was shorter by ~1 day, and patient self-care was better in the study group. When the Fast-track principle is used with intermediate-acting SA and early rehabilitation, it is possible to reduce post-operative pain during movement, reduce the length of stay and improve patient self-care abilities.
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Birznieks et al. (2019) studied this question.
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