The preoperative analgesic effect of 3-in-1 block on postoperative pain and tramadol consumption in total hip arthroplasty

• Published in: Aǧrı Vol. 20; no. 1; pp. 19 - 25
• Main Authors: Köroğlu, Süleyman, Takmaz, Suna Akin, Kaymak, Cetin, Narli, Altuğ, Karalezli, Kubilay, Dikmen, Bayazit
• Format: Journal Article
• Language: English
• Published: Turkey 01.01.2008
• Subjects: Analgesia, Patient-Controlled - methods; Analgesics - administration & dosage; Analgesics - therapeutic use; Analgesics, Opioid - administration & dosage; Analgesics, Opioid - therapeutic use; Arthroplasty, Replacement, Hip - methods; Bupivacaine - therapeutic use; Drug Administration Schedule; Hip Joint; Humans; Infusions, Intravenous; Intraoperative Period; Movement - drug effects; Movement - physiology; Nerve Block - methods; Pain Measurement; Pain, Postoperative - drug therapy; Pain, Postoperative - prevention & control; Patient Satisfaction; Preoperative Care; Tramadol - administration & dosage; Tramadol - therapeutic use
• ISSN: 1300-0012

We studied the effect of preoperative 3-in-1 block for total hip replacement surgery on postoperative pain and tramadol consumption during patient-controlled analgesia. Thirty ASA I-II patients undergoing elective total hip arthroplasty (THA) were included in the study. Patients were randomly divided into 2 groups; Group I: Patients who received 3-in-1 block with 40 ml of 0.25% bupivacaine 30-minutes before surgery and later received general anesthesia, Group II: Patients who received only a simple needle puncture at the operation site 30-minutes before surgery and later received general anesthesia. All patients received intravenous tramadol at the end of surgery via a PCA device. Pain was evaluated at 0,1/2,1,4,8,12,24 and 48 h at rest and on movement of the hip, using a 10 cm VAS. The average intraoperative fentanyl consumption was lower in Group I than in Group II. VAS scores were significantly lower in group I, both at rest and during movement at all timepoints over in the first postoperative 12 h and also during movement 24 h postoperatively. However differences in VAS scores weren't clinically significant after 4 hours. In the recovery room, Group I VAS scores were only a third of Group II, both at rest and movement (p=0.0001). Total tramadol consumption was lower in Group I (633.0+/-119.3 mg) than in Group II (991.1+/-41.0 mg). Patient satisfaction scores were higher in Group I than in Group II. We concluded that preoperative 3-in-1 block with 40 ml-0,25% bupivacaine provides effective postoperative pain relief for elective THA, reducing intra-and postoperative analgesic consumption without increase in side effects.