[COMBINED SPINAL-PARAVERTEBRAL ANESTHESIA IN TOTAL HIP ARTHROPLASTY.]

Area of Science:

• Anesthesiology
• Orthopedic Surgery
• Pain Management

Background:

• Optimizing analgesia after total hip arthroplasty (THA) led to exploring combined spinal and paravertebral anesthesia.
• Evaluating novel anesthetic techniques is crucial for improving patient outcomes in THA.

Purpose of the Study:

• To clinically evaluate the efficacy and safety of combined spinal-paravertebral anesthesia (KSPA) in patients undergoing total hip arthroplasty.
• To compare KSPA with combined spinal-epidural anesthesia (CSEA) for THA pain management.

Main Methods:

• Sixty-seven patients undergoing THA were randomized into KSPA and CSEA groups.
• Ultrasound guidance was used to locate the lumbar plexus for anesthesia delivery.
• Postoperative pain was assessed using a 10-point visual analog scale (VAS), and complications and patient satisfaction were recorded.

Main Results:

• Both KSPA and CSEA groups reported postoperative pain intensity not exceeding 3 on the VAS within 48 hours.
• The complication rate was lower in the KSPA group (18.2%) compared to the CSEA group (26.5%).
• Patient satisfaction was high in both groups, with 90.1% in the KSPA group and 82.4% in the CSEA group reporting full satisfaction.

Conclusions:

• Combined spinal-paravertebral block is an effective and safe anesthetic technique for managing pain after total hip arthroplasty.
• KSPA offers comparable or superior pain relief and patient satisfaction with a potentially lower complication rate than CSEA.