Comparison of patient-controlled epidural and intravenous analgesia methods for postoperative pain control in patients after hip surgery

Abstract

Objective: Patients undergoing total hip arthroplasty surgery are usually older and have limited cardiac and pulmonary reserves. Effective postoperative pain control with patient-controlled analgesia (PCA) may contribute to recovery in these patients. In this study, we aimed to compare the effectiveness of patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (PCIA) for pain control after hip arthroplasty. Methods: Our study was carried out in the orthopedic operating room of our hospital on 50 patients undergoing elective hip arthroplasty. At the end of the operation, the patients (n=50) were randomly divided into two groups: Group epidural (Group E) and Group intravenous (Group IV)] using a double-blind selection method, and PCA protocol was started. During the determined follow-up periods, the patients were evaluated regarding hemodynamic data, pain and sedation levels, and possible side effects. Results: In our study, no difference was observed between demographic data, heart rate, respiratory rate and mean blood pressure values ​​in comparisons between two groups. In Group IV compared to Group E, visual analog scale (VAS) values ​​(P<0.001), additional analgesic consumption (P<0.05) and undesirable effects such as nausea-vomiting and sedation (P<0.05) which were observed in postoperative pain follow-up were statistically significantly higher. Conclusion: Our study concluded that for postoperative pain management, the PCEA method has better analgesic performance, improves pain control and reduces the occurrence of side effects in hip arthroplasty compared to the PCIA method.