Comparative Evaluation of Continuous Lumbar Paravertebral Versus Continuous Epidural Block for Post-Operative Pain Relief in Hip Surgeries
Authors
Pankaj N Surange1,*, Brig Chadalavada Venkata Rama Mohan2
1Interventional Pain and Spine Centre, New Delhi, India
2Armed Forces Medical College, Pune, India
*Corresponding Author: Interventional Pain and Spine Centre, New Delhi, India. Tel: +91-9871985514, Fax: +91-1145254530, pankajnsurange@yahoo.co.in. Email: pankajnsurange@yahoo.co.in
How to Cite:N Surange P, Venkata Rama Mohan BC. Comparative Evaluation of Continuous Lumbar Paravertebral Versus Continuous Epidural Block for Post-Operative Pain Relief in Hip Surgeries. Anesth Pain Med. 2011;1(3):. doi: https://doi.org/10.5812/kowsar.22287523.3348
Abstract
Background:
Effective control of postoperative pain remains one of the most important and pressing issues in the field of surgery and has a significant impact on our health care system. In too many patients, pain is treated inadequately, causing them needless suffering and they can develop complications as an indirect consequence of pain. Analgesic modalities, if properly applied, can prevent or at least minimize this needless suffering and these complications.
Objectives:
The aim of this study was to compare the efficacy of continuous infusions of local anesthetic drugs by paravertebral and epidural routes in controlling postoperative pain in patients undergoing hip surgeries.
Patients and Methods:
The study involved 60 patients who were undergoing hip surgery under the subarachnoid block. They were randomly divided into 2 groups of 30 patients. Group I (paravertebral group) received a single dose of spinal anesthesia with 2.5 mL 0.5% bupivacaine (heavy) + a continuous infusion of 0.125% bupivacaine at 5 mL/h in the paravertebral space. Group II (epidural group) received a single dose of spinal anesthesia with 0.5% bupivacaine (heavy) + a continuous infusion of 0.125% bupivacaine at a rate of 5 mL/hr in the epidural space for 48 hours in the postoperative period. Visual analogue scale (VAS) score, vital statistics, rescue analgesia, and procedure time were compared with the corresponding times between the 2 groups by students t-test and repeated measures ANOVA with post hoc Bonferroni. P < 0.05 was considered significant. There were no statistically significant differences between the 2 groups regarding mean pain score in the first 48 hours.
Results:
Mean arterial pressure was significantly lower in the epidural group compared with the paravertebral group from 2 hours after start of the infusion until 48 hrs. Regional anesthesia procedure time was significantly longer in the epidural group (P < 0.001). There was no significant difference between the 2 groups regarding frequency of postoperative complications and catheter-related problems.
Conclusions:
The results of our study indicate that for patients who are scheduled for hip surgery, both continuous paravertebral and continuous epidural analgesia are effective in controlling postoperative pain but that the former has several crucial advantages.
Jafari-Javid M, Heshmati F, Agdashi M, Mahoori A, Noroozinia H, et al. Evaluation of the effect of added fentanyl to hyperbaric bupivacaine for spinal anesthesia. Zahedan J Res Med Sci. 2011;12(5):e94222. doi:
JN S, BC P, Savitha LM, Kalaburgi RA. Comparison of Epidural Bupivacaine and Buprenorphine to Bupivacaine and Butorphanol for Postoperative Analgesia in Lower Limb Orthopedic Surgery. Anesth Pain Med. 2023;13(2):e132686. doi: https://doi.org/10.5812/aapm-132686
Moslemi F, Rasooli S, Baybordi A, Golzari SE. A Comparison of Patient Controlled Epidural Analgesia With Intravenous Patient Controlled Analgesia for Postoperative Pain Management After Major Gynecologic Oncologic Surgeries: A Randomized Controlled Clinical Trial. Anesth Pain Med. 2015;5(5):e29540. doi: https://doi.org/10.5812/aapm.29540
Hammod HA, Pestehei SK, Malek M, Shamsi A, Montaseri A. Comparison of Spinal Anesthesia Bupivacaine Plus Epinephrine and Spinal Anesthesia Bupivacaine Plus, Fentanyl in the Duration of Anesthesia, Complications, and Hemodynamic Changes. Arch Neurosci. 2025;12(3):e163729. doi: https://doi.org/10.5812/ans-163729
Gousheh M, Akhondzadeh R, Rashidi M, Olapour A, Moftakhar F. Comparison of Dexmedetomidine and Morphine as Adjuvants to Bupivacaine for Epidural Anesthesia in Leg Fracture Surgery: A Randomized Clinical Trial. Anesth Pain Med. 2019;9(4):e91480. doi: https://doi.org/10.5812/aapm.91480
