
ARTHROPLASTY
Comparison of epidural analgesia vs. periarticular injection after total hip arthroplasty
J Bone Joint Surg Am. 2015 May 20;97(10):789-9890 patients scheduled for total hip arthroplasty were randomized to receive either a periarticular injection at the end of the procedure and sustained-release oxycodone (10mg) for postoperative analgesia, or patient-controlled epidural analgesia with bupivacaine and hydromorphone. The primary outcome was time to discharge readiness. Additional outcomes included numeric rating scale (NRS) for pain, opioid consumption, opioid-related symtoms on the Opioid-Related Symptom Distress Scale (ORSDS), patient satisfaction and the Quality of Recovery (QoR)-40 patient survey. Results demonstrated no significant differences in time to discharge readiness between groups. Over the first 3 postoperative days, overall pain over time during walking and physical therapy was higher with periarticular injection, as well oral opioid consumption. In the same time frame, opioid-related symptoms were higher with patient-controlled epidural analgesia. Patient satisfaction and quality of recovery were rated similarly between groups.
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