Analgesia after total hip replacement: epidural versus psoas compartment block

Abstract

Background: The objective of this paper is to evaluate the effectiveness of a psoas compartment block, as compared with an epidural, for postoperative analgesia following total hip replacement surgery. The research design was a double-blinded randomised control trial, in the setting of a university hospital.

Methods: Patients scheduled for hip arthroplasty received either a psoas compartment or epidural infusion of bupivacaine. The outcome measures that were examined were postoperative pain, local anaesthetic and morphine consumption, and side effects.

Results: There was no significant difference between the two groups regarding postoperative pain. Local anaesthetic and opiate consumption was significantly higher in the psoas compartment block group. Postoperative morphine as covariate had a significant influence on the mean postoperative pain. There was no significant difference between side effects in each group.

Conclusion: Epidural analgesia was more effective than the psoas compartment block after hip replacement surgery. Although pain did not differ significantly, local anaesthetic and opiate consumption was significantly higher in the psoas compartment group.