Intraarticular Analgesia After Total Hip Arthroplasty, a Randomised Study
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Purpose
The purpose of this study is to determine whether wound infiltration with following single-shot bolus injection with local anesthetic and NASIDs are effective in the treatment of postoperative pain after total hip replacement compared to continuous epidural infusion.
| Condition | Intervention | Phase |
|---|---|---|
|
Arthroplasty, Replacement, Hip |
Drug: Epidural Ropivacaine, morphine Drug: Ropivacaine, Ketorolac and Adrenaline |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Postoperative Analgesia After Total Hip Arthroplasty. A Comparison of Continuous Epidural Infusion and Wound Infiltration With Intraarticular Bolus Injection. |
- Consumption af analgesics [ Time Frame: 96 h ] [ Designated as safety issue: No ]
- Side effects [ Time Frame: 96 h ] [ Designated as safety issue: Yes ]
- Mobilization level [ Time Frame: 8 h ] [ Designated as safety issue: No ]
- Pain scores VAS [ Time Frame: 96 h ] [ Designated as safety issue: No ]
| Enrollment: | 80 |
| Study Start Date: | February 2005 |
| Study Completion Date: | March 2006 |
| Primary Completion Date: | February 2006 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: A |
Drug: Epidural Ropivacaine, morphine
Infusion rate 4 ml/h in 48 h Solution 200 ml Ropivacaine 2mg/ml added 1 ml morphine 10 mg/ml
|
| Experimental: B |
Drug: Ropivacaine, Ketorolac and Adrenaline
Wound infiltration: 100 ml Ropivacaine 2 mg/ml added 1 ml Ketorolac 30 mg/ml and 0,5 ml adrenaline 1 mg/ml Bolus injection: 20 ml Ropivacaine 7,5mg/ml added 1 ml Ketorolac 30 mg/ml and 0,5 ml adrenaline 1 mg/ml
|
Detailed Description:
Sufficient postoperative pain relief after total hip replacement is necessary to achieve normal mobilisation and a reduction of the surgical stress response. After total hip replacement epidural treatment has proven superior, with regards to pain relief, than treatment with parenteral infusions and periphery nerve blocks. Even though epidural treatment gives excellent pain relief adverse effect as motor block, urine retention, hypotension and itching occurs regularly which delays rehabilitation.
Treatment with the administration of local anesthetic in the operating field has shown its efficiency in reducing postoperative pain with a low incidence of adverse effects after various surgical procedures.
This study compares continuous epidural infusion of ropivacaine added morphine to a new technique, where ropivacaine, ketorolac and adrenaline is used to infiltrate the tissue around the hip joint during surgery, and is injected by an intraarticular catheter 8 hours postoperative.
Data of pain scores, analgesia consumption, adverse effects and mobilisation is collected for the first 4 postoperative days.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients admitted consecutively to primary total hip arthroplasty due to arthrosis
Exclusion Criteria:
- Patients unable to provide informed consent
- Patients with contraindications for spinal anesthesia
- Patients with known hypersensitivity towards the used drugs
- Patients with severe chronic neurogenic pain
- Patients with Rheumatoid arthritis
- Patients with a daily opioid consumption
Contacts and Locations| Denmark | |
| Orthopedic Center, Aarhus University Hospital | |
| Aarhus, Denmark, 8000 | |
| Principal Investigator: | Kjeld Søballe, Professor | Orthopedic Center, Aarhus University Hospital, Aarhus, Denmark |
More Information
No publications provided
| Responsible Party: | Professor Kjeld Soballe, University of Aarhus |
| ClinicalTrials.gov Identifier: | NCT00289419 History of Changes |
| Other Study ID Numbers: | 20040199 |
| Study First Received: | February 8, 2006 |
| Last Updated: | May 6, 2008 |
| Health Authority: | Denmark: The Danish National Committee on Biomedical Research Ethics |
Keywords provided by University of Aarhus:
|
Arthroplasty, Replacement, Hip Anesthetics, Local Pain, Postoperative |
Additional relevant MeSH terms:
|
Epinephrine Epinephryl borate Morphine Ketorolac Ketorolac Tromethamine Ropivacaine Adrenergic beta-Agonists Adrenergic Agonists Adrenergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Physiological Effects of Drugs Bronchodilator Agents Autonomic Agents |
Peripheral Nervous System Agents Anti-Asthmatic Agents Respiratory System Agents Therapeutic Uses Mydriatics Adrenergic alpha-Agonists Sympathomimetics Vasoconstrictor Agents Cardiovascular Agents Analgesics, Opioid Analgesics Sensory System Agents Central Nervous System Agents Central Nervous System Depressants Narcotics |
ClinicalTrials.gov processed this record on May 22, 2013