UNILATERAL EPIDURAL ANALGESIA AFTER TOTAL KNEE JOINT REPLACEMENT
https://doi.org/10.21292/2078-5658-2015-12-4-20-25
Abstract
The randomized prospective study presents the comparative evaluation of efficiency of unilateral and traditional epidural analgesia after total knee joint replacement. The administration of traditional and unilateral epidural analgesia through continuous infusion of ropivacainum was characterized by the adequate post-surgery pain relief. The targeted lateral catheterization towards the surgery side provided preferable development of the sensor and motor block on the surgery side with bigger analgesic effect at rest and lower consumption of local anesthetic compared to traditional administration of epidural catheter.
About the Authors
V. V. Kuzmin
Center of Cosmetology and Plastic Surgery, Yekaterinburg;
Ural State Medical University, Yekaterinburg
Russian Federation
Russian Federation
N. N. Shadursky
Center of Cosmetology and Plastic Surgery, Yekaterinburg
Russian Federation
Russian Federation
References
1. Garyaev R.V., Rychkov I.A. Evaluation of impact of continuous epidural anesthesia on lower limbs on muscle strength after total endoprosthesis replacement of the knee joint. Vestnik Anasteziol. i Reanimatol., 2015, vol. 12, no. 2, pp. 47-53. (In Russ.)
2. Koryachkin V.А., Strashnov V.I., Khryapa А.А. et al. Unilateral spinal anesthesia. Anesteziol. i Reanimatol., 2008, no. 4, pp. 4-5. (In Russ.)
3. Lakhin R.E. Dose-dependency of regress of unilateral spinal anesthesia. Vestnik Anasteziol. i Reanimatol., 2014, vol. 11, no. 6, pp. 14-20. (In Russ.)
4. Ovechkin А.M., Bastrikin S.Yu. Protocol of spinal epidural anesthesia and post-surgery epidural analgesia for total replacement of big joints of lower limbs. Regionar. Anestesia i Lecheniye Ostroy Boli, 2007, vol. 1, no. 2, pp. 79-81. (In Russ.)
5. Asato F., Goto F. Radiographic findings of unilateral epidural block. Anesth. Analg., 1996, vol. 83, no. 3, pp. 519-522.
6. Borghi B., Agnoletti V., Ricci A. et al. A prospective, randomized evaluation of the effects of epidural needle rotation on the distribution of epidural block. Anesth. Analg., 2004, vol. 98, no. 5, pp. 1473-1478.
7. Buchheit T., Crews J.C. Lateral cervical epidural catheter placement for continuous unilateral upper extremity analgesia and sympathetic block. Reg. Anesth. Pain Med., 2000, vol. 25, no. 3, pp. 313-317.
8. Casati A., Fanelli G. Unilateral spinal anesthesia. State of the art. Minerva Anestesiol., 2001, vol. 67, no. 12, pp. 855-862.
9. Choi P.T., Bhandari M., Scott J., Douketis J. Epidural analgesia for pain relief following hip or knee replacement. Cochrane Database Syst. Rev., 2003, vol. 3: CD003071.
10. Fischer H.B., Simanski C.J., Sharp C. et al. A procedure-specific systematic review and consensus recommendations for postoperative analgesia following total knee arthroplasty. Anaesthesia, 2008, vol. 63, no. 10, pp. 1105-1123.
11. Fukushige T., Kano T., Sano T. Radiographic investigation of unilateral epidural block after single injection. Anesthesiology, 1997, vol. 87, no. 6, pp. 1574-1575.
12. Hogan Q. Epidural catheter tip position and distribution of injectate evaluated by computed tomography. Anesthesiology, 1999, vol. 90, no. 4, pp. 964-970.
13. McCrae A.F., Whitfield A., McClure J.H. Repeated unilateral epidural block. Anaesthesia, 1992, vol. 47, no. 10, pp. 859-861.
14. Rawal N. Epidural technique for postoperative pain: gold standard no more? Reg. Anesth. Pain Med., 2012, vol. 37, no. 3, pp. 310-317.
15. Rigg J.R., Jamrozik K., Myles P.S. et al. Epidural anaesthesia and analgesia and outcome of major surgery: A randomized trial. Lancet, 2002, vol. 359, no. 9314, pp. 1276-1282.
16. Sala-Blanch X., Izquierdo E., Fita G. et al. Maintained unilateral analgesia. Acta Anaesthesiol. Scand., 1995, vol. 39, no. 1, pp. 132-135.
17. Wheatley R.G., Schug S.A., Watson D. Safety and efficacy of postoperative epidural analgesia. Br. J. Anaesth., 2001, vol. 87, no. 1, pp. 47-61.
Review
For citations:
Kuzmin V.V., Shadursky N.N. UNILATERAL EPIDURAL ANALGESIA AFTER TOTAL KNEE JOINT REPLACEMENT. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2015;12(4):20-25. (In Russ.) https://doi.org/10.21292/2078-5658-2015-12-4-20-25
Email this article 