Postoperative analgesia after total hip replacement surgery for the purpose of comparison of intravenous and epidural patient-controlled analgesia

Objectives: Hip arthroplasty is one of the major surgerics in orthopedia and therefore patients suffer serious pain after surgery. This pain feeling has a negative effect in the patients rehabilitations. In this study, we aimed to comparewith evaluate the postoperative epidural and intravenous PCA methods for analgesic efficiacy side effects, patient and surgeon comfort in these patients that had hip arthroplasty surgery under general anesthesiaMethods: After Local Ethic Board B.30.2.BAV.0.05.05/260-9/5 approval, this study was conducted in BVU faculty of Anesthesia and Reanimation, Orthopedia and Traumatology operating room and Orthopedia and Traumatology clinic. Fourty patients that were 40-80 years old, ASA I-III and that will have unilateral total or partial hip arthroplasty were included in the study. Patients were divided into 2 groups in a randomised way. Patients that have general anesthesia and epidural PCA were named as ?Group I (EA)? and the patients that had IV PCA were named as ?Group II (GA)?Both groups of patients were operated under general anesthesia regarding our standart general anesthesia aplication protocol Epidural PCA device was prepared for Group I. Bupivacaine %0,125 + Fentanyl 1µcg/ml were used and the device was set to 8 ml looding dose, 6 ml infusion, 4 ml bolus and 20 minutes lock-out time.IV PCA device was prepared for Group II, and the device was set to 30 µcg Fentanyl loading dose, 20 µcg/h Fentanyl infusion, 30 µcg Fentanyl bolus and 20 minutes lock out time.Results: Demographic data, heart rate, mean arterial pressure, PCA application times and patient satisfaction scores didn?t differ between groups. VAS score was lower in all time zones in Group I (p<0,05) fentanyl consumption in all time zones were significantly lower in Group I (p<0,05). CMS were signicantly different in 24 and 48 hours between groups.Conclusion: As a result, we found that Bupivacain + Fentanyl combination in epidural PCA might be on appropiate combination for postoperative analgesia, also it has more analgesic efficiency less side effects, and better CMS score compared to IV Fentanyl PCA application.Keywords: Hip arthroplasty, Postoperative pain, Patient controlled analgesia, Postoperative rehabilitation