The effects of two different multimodal analgesic regimens in total hip replacement surgery

Abstract

Objectives: This study evaluated the effectiveness of two different multimodal analgesia protocols in terms of postoperative pain relief, tramadol consumption during patient-controlled analgesia (PCA) and side effects after total hip replacement surgery.
Methods: Group F (n=18) received general anesthesia after a 3-in-1 femoral nerve block (FNB) was applied using 40 ml of bupivacaine 0.25%. Group FD (n=18) received general anesthesia after the same block and dexketoprofen p.o. was given. All patients received intravenous tramadol at the end of surgery via a PCA device. Group FD was given dexketoprofen 75 mg/day for 48 hours postoperatively. Pain scores were evaluated at 0, 1/2, 1, 4, 8, 12, 24 and 48h at rest and on movement of the hip. Side effects and global satisfaction scores in both groups were also evaluated in this setting. Results: Total tramadol consumption was lower in Group FD (377.7±137.4) than in Group F (593.9±132.3) (p<0.05). Visual analogue scale (VAS) scores were ≤3 in all follow-up periods in both groups. While in Group FD, 6 patients had nausea, 3 vomiting and 1 sedation, in Group F, 5 patients had nausea, 3 vomiting and 2 sedation. Patient global satisfaction scores in Group F were very good in 14 patients and good in 4 patients, and in Group FD were very good in 13 patients and good in 5 patients. Conclusion: Both analgesia protocols were effective in pain relief in total hip replacement patients, with similar side effects. The effect of additional dexketoprofen was to reduce postoperative tramadol consumption.