Clinical Evaluation for Effectiveness and Safety of Lidocaine and Bupivacaine Combination Epidural Infusion for the Management of Post-Total Hip Replacement Pain

Abstract

Background
 The management of post-operative pain is critical for both the patient and the surgical outcome. Although epidural analgesia is valuable method, optimal local anesthetic selection and combination could improve its effectiveness. To determine the effectiveness and safety of bupivacaine and lidocaine bolus epidural analgesia in the management of post-total hip arthroplasty.
 Methods 
 65 Records of patients who underwent total hip arthroplasty and received bolus epidural analgesia with bupivacaine and lidocaine were evaluated retrospectively. The numerical pain score for 48 hours, drug adverse effects, hospital stay, and opioid intake were analyzed statistically to determine the effectiveness and safety of epidural analgesia.
 Results
 The numerical pain score showed mild pain perception through the first 48 hours post operatively. There was no significant difference (p≥ 0.005) between the first score data collected at 6 hours and the last score at 48 hours. Post-operatively, patients had lower incidence of hypotension and headache with acceptable mobility. Opioid rescue analgesia was used for 11(16.9%) of patients.
 Conclusions
 For patients who have undergone total hip replacement surgery, epidural analgesia with a bolus epidural infusion of lidocaine and bupivacaine delivers an effective and safe pain control method for 48 hours. This method was effective in opioid sparing.