Comparative study between: Epidural bupivacaine versus Patient Controlled Analgesia for postoperative pain control in total knee arthroplasty

Abstract

knee replacement is a common operative procedure to improve mobility and quality of life. Adequate pain relief is fundamental in the postoperative period to enable ambulation and initiation of physiotherapy. The analgesic regimen needs to meet the goals of providing safe, effective analgesia, with minimal side effects for the patient, together with inhibition of trauma –induced nociceptive impulses. Good analgesia helps blunting the autonomic and somatic reflex responses to pain and enhances subsequent restoration of the function of different body-organs as breathing, coughing, together with early mobilization and rehabilitation for early hospital discharge. The aim of this study is to assess the analgesic efficacy and hemodynamic effects of epidural bupivacaine compared with intravenous patient controlled analgesia (opioid and NSAIDs) during postoperative period in total knee arthroplasty. The study was conducted on 40 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 20 patients each: