[Gastrointestinal Tonometry in Orthopaedics (Results of a Prospective Randomized Pilot Study GATOAN-1 in Patients with General and Regional Anaesthesia During Replacement of the Hip Joint).]

In the submited pilot study the authors present a recently introduced method of monitoring of the regional perfusion by gastric tonometry during implantation of an endoprosthesis of the hip joint. The objective of the investigation was in addition to introduction of a new method to assess the influence of the type of anaesthesia on markers of the gastrointestinal tract perfusion. The method was used in 10 patients aged 27 - 75 years where in four instances a cemented endoprosthesis was implanted and an uncemented one in six cases. Five times general anaesthesia was used, 5 times regional anaesthesia. During monitoring the authors assessed PrCO2, pHi, CO2 gap, pH gap, EtCO2, arterial pressure, heart rate and SaO2. The patients operated under general anaesthesia had all pathological values of pHi, two had pathological values of pH gap and one of CO2 gap. In the group with regional anaesthesia three patients had pathological pHi values, two had pathological pH gap values and one a pathological CO2 gap value. Statistical evaluation revealed a significant difference in pH gap and CO2 gap values in favour of regional anaesthesia (p = 0,03). The results of the trial indicate a better gastrointestinal perfusion in patients under regional anaesthesia and a pathological state of organ perfusion while the values of standard systemic values are unaltered. Key words: gastrointestinal tonometry, general anaesthesia, regional anaesthesia, total replacement of the hip joint.