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Pain relief after total hip replacement: oral CR oxycodone plus IV paracetamol versus epidural levobupivacaine and sufentanil. A randomized controlled trial.
MedLine Citation:
PMID:  22327039     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:We tested the hypothesis that pain relief after total hip replacement (THR) can be obtained with a multimodal approach using oral controlled release (CR) oxycodone plus IV paracetamol. METHODS:260 patients undergoing THR were randomized into two groups. A group of 130 patients (EPI) under epidural anesthesia followed by continuous infusion of levobupivacaine 0.125% and sufentanil 0.7mcg/mL at 7 mL/h was compared with a group (OXY) of 130 patients under spinal anesthesia and oral CR oxycodone 10 mg/q12h plus IV paracetamol 1g/q6h. Pain intensity at rest and dynamic by visual analogue scores (VAS), rescue dose consumption and side effects of three postoperative days (POD) were collected and analyzed with Mann-Withney test (p<0.05 was considered significant). RESULTS:VAS values at rest were similar in both groups at POD#1, significantly lower in the OXY group either at POD#2 (p=0.018) and POD#3 (p=0.001). Dynamic VAS values were significantly lower in the EPI group at POD#1 (p=0.001), similar for both groups at POD#2 and significantly lower in the OXY group at POD#3 (p=0.026) than the comparing group. Rescue dose consumption was significantly lower in the EPI group during the POD#1 (p=0.009), similar for both groups at POD#2 and higher in the EPI at POD#3 (p=0.008). The incidence of vomiting was similar for the two groups. Nausea was more frequent in the OXY group at POD#3 and more hypotension events occurred in the OXY group at POD#2. CONCLUSION: Oral CR oxycodone plus IV paracetamol was as effective as epidural levobupivacaine and sufentanil for postoperative pain relief after THR.
Authors:
M Divella; M Cecconi; N Fasano; N Langiano; M Buttazzoni; I Gimigliano; G Della Rocca
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-10
Journal Detail:
Title:  Minerva anestesiologica     Volume:  -     ISSN:  1827-1596     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375272     Medline TA:  Minerva Anestesiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Anesthesia and Intensive Care Medicine - divella.michele@aoud.sanita.fvg.it.
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