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June 1, 1976Acta Anaesthesiologica Scandinavica

Respiration and Circulation after Total Hip Replacement Surgery

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Why the study?

Does continuous lumbar epidural analgesia compared to intramuscular pentazocine improve postoperative cardiopulmonary function in healthy patients undergoing total hip replacement surgery?

Population

31 cardiorespiratorily healthy patients subjected to total hip replacement surgery.

Comparison

Continuous lumbar epidural drip for analgesia… vs Pentazocine intramuscularly on demand for pain…

Design

Cohort

Follow-up

3 days postoperatively

Authors

JMJ. ModigUppsala University

Discussion

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Overview

Epidural analgesia was associated with preserved pulmonary function versus pentazocine post-hip replacement; leaves open effects on outcomes in randomized trials.

Key Points

  • To compare the cardiopulmonary effects of continuous lumbar epidural analgesia versus intramuscular pentazocine in patients recovering from total hip replacement surgery.
  • Assessed 31 cardiorespiratorily healthy patients undergoing total hip replacement preoperatively and across the first three postoperative days.
  • Assigned patients postoperatively to receive either intramuscular pentazocine on demand (n=10), continuous lumbar epidural plain 0.4% lidocaine (n=14), or continuous lumbar epidural 0.4% lidocaine with adrenaline (n=7).
  • Patients receiving intramuscular pentazocine developed a significant increase in pulmonary venous admixture caused by true shunting and ventilation/perfusion disturbances that persisted through day 3.
  • Continuous lumbar epidural analgesia caused no significant changes in pulmonary venous admixture, successfully preserving postoperative arterial oxygen tension (PaO2).
  • Both regimens showed increased postoperative oxygen uptake and cardiac index, with epidural analgesia producing a greater increase in cardiac index toward hyperkinetic circulation.

Structured PICO

Does continuous lumbar epidural analgesia compared to intramuscular pentazocine improve postoperative cardiopulmonary function in healthy patients undergoing total hip replacement surgery?

P
Population
31 cardiorespiratorily healthy patients subjected to total hip replacement surgery.
I
Intervention
Continuous lumbar epidural drip for analgesia using 0.4% plain lidocaine (n=14) or 0.4% lidocaine with adrenaline (n=7).
C
Comparator
Pentazocine intramuscularly on demand for pain relief (n=10).
O
Outcome
Postoperative arterial oxygenation and pulmonary venous admixture.surrogate

Epidural analgesia preserves postoperative pulmonary function better than intramuscular pentazocine in patients undergoing total hip replacement.

Cite This Study

J. Modig (1976) studied this question.

synapsesocial.com/papers/6a8ea795af8fd2d347938591https://doi.org/10.1111/j.1399-6576.1976.tb05034.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effects of thoracic epidural anaesthesia on central haemodynamics compared to cardiac beta adrenoceptor blockade in conscious rats with acute myocardial infarction1990 · 79 citations
  2. 2The mechanism of hypoxaemia after laparotomy1967 · 39 citations
  3. 3The Effects of Postoperative Epidural Analgesia Versus Centrally Acting Opiate on Physiological Shunt After Upper Abdominal Operation1972 · 20 citations
  4. 4Circulatory Effects of Peridural Block1973 · 148 citations
  5. 5Post-operative Hypoxaemia and Oxygen Therapy1963 · 58 citations