Caudal epidural anesthesia administered intraoperatively provides for effective postoperative analgesia after total hip arthroplasty

Abstract

Study Objective To investigate the use of caudal epidural anesthesia for postoperative pain after total hip arthroplasty. Design Prospective study. Setting University-affiliated hospital. Patients 32 (4 men and 28 women) patients, aged 49 to 89 years, scheduled for total hip arthroplasty for osteoarthritis of the hip. Interventions and Measurements Patients were allocated to three groups: lumbar epidural anesthesia (EA group; n = 16) or caudal epidural anesthesia (CA group; n = 16) groups, which were case-matched according to patient demographics. Nine patients received general anesthesia only (GA group). We evaluated the level of postoperative pain using a 100-mm Visual Analog Scale (VAS) recorded at 3, 6, 9, 12, and 24 hours after surgery. Main Results Total requirement of diclofenac sodium suppositories was significantly larger in the GA group than in the EA or CA groups (444 ± 302 vs 188 ± 124 and 145 ± 130 mg). The number of days requiring analgesics was significantly prolonged in the GA group compared with the EA or CA groups (14 ± 9 vs 4 ± 3 and 4 ± 4 days). These items were similar between the EA group and the CA group. All VAS values for pain, rest, and movement in the postsurgical period over 24 hours were significantly higher in the GA group than in either the EA or CA groups. Conclusions Caudal epidural anesthesia provides effective postoperative analgesia similar to lumbar epidural anesthesia.