Postoperative Pain Clinical Trial
Official title:
A Comparison of 0.1 and 0.2% Ropivacaine in Lumbar Plexus Catheters After Primary Total Hip Arthroplasty: a Comparison of Postoperative Analgesia and Motor Function.
Peripheral nerve blocks are the standard of care for pain management after hip replacement
surgery at UPMC Shadyside. This prospective, randomized study is intended to assess the
effect of 0.1 versus 0.2% ropivacaine in lumbar plexus nerve catheter infusions after total
hip arthroplasty. Ropivacaine peripheral nerve block infusions have been utilized as the
standard of care at UPMC Shadyside for many years. Ropivacaine, a less potent left-isomer of
bupivacaine, is often used in place of bupivacaine due to less motor blockade and less severe
cardiovascular and central nervous system potential toxicity.
The primary goal of this study to examine the effect of a low concentration infusion of
ropivacaine (0.1%) on postoperative analgesia (evaluated by opioid consumption after 36
hours) compared with the standard accepted concentration of 0.2% ropivacaine in lumbar plexus
catheters after primary total hip arthroplasty. Secondary goals are to examine motor
function, VAS scores and patient satisfaction with pain control in low concentration 0.1%
ropivacaine compared with 0.2% ropivacaine lumbar plexus infusions upto 36 hours after
primary total hip arthroplasty.
Lumbar plexus catheters are the standard of care for postoperative pain management following total hip arthroplasty (THA) at UPMC Shadyside. The safety and efficacy of this technique has been demonstrated by multiple studies. Ropivacaine 0.2% was used for many years at UPMC Shadyside and throughout the UPMC system and this concentration of ropivacaine is the standard local anesthetic utilized by multiple other studies. However, this concentration of ropivacaine was later decreased to 0.1% in our institution in order to decrease patient's motor weakness and promote postoperative physical therapy. Patients were clinically observed to continue to have adequate postoperative analgesia while demonstrating improved motor function. A randomized, double blinded clinical trial has never compared 0.1 and 0.2% ropivacaine. ;
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