Total Hip Replacement Clinical Trial
Official title:
Local Analgesia Versus Local Peroperative Infiltration After Total Hip Replacement
Clinical study, comparative, prospective, interventional, randomized, single-center,
single-blind The fast resumption of the walking after surgery of total prosthesis of hip
(PTH) requires an effective analgesia from the immediate post-operative period. In France,
whatever is the peroperative anesthesia, the analgesic reference technique is a locoregional
anesthesia (ALR) ultrasound guidance by blocks of the femoral and cutaneous nerves side of
the thigh. In the Anglo-Saxon countries, in particular in Australia and in the United States,
the techniques of peroperative infiltration of local anesthetics (IAL) by the surgeon
supplanted the techniques of traditional ALR. However, no French study compares the IAL with
the conventional ALR with a rigorous methodology. Our occasional practice of IAL suggests us
that it is more effective in terms of post-operative analgesia with Analog Visual Scales
decreased (EVA) and a lesser consumption of morphine. Furthermore, the resumption of the
upright posture in bipedal support as well as the resumption of the walking would be earlier.
The main objective is to show that the post-operative analgesia by local peroperative
infiltration is superior to that obtained by locoregional anesthesia (ALR by femoral block
associated with a side cutaneous block of the thigh) after the surgery of total prosthesis of
hip, with decrease of the consumption of morphine within first 72 post-operative hours.
The secondary objectives are to compare the Analog Visual Scales of pain (EVA) with the rest
and with the mobilization during various times (in post-surgery care room, then at H4, H8,
H12, H24, H48, H72), the period between the end of intervention (out of the operating room)
and the first support by the upright posture in bipedal support), the period between the end
of intervention and the resumption of the walk, the satisfaction of the patients at the exit
of the hospital, the duration of hospitalization after the surgical operation and the
possible unwanted events (systematic toxicity of the local anesthetics, the infection of
prosthesis, disease thromboembolic venous) during the hospitalization.
n/a
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