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ISSN: Print -2349-0977, Online - 2349-4387
Year : 2018  |  Volume : 4  |  Issue : 4  |  Page : 221-226

Comparison of psoas compartment block and epidural block for postoperative analgesia in hip surgeries

Department of Anaesthesia and Intensive Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

Correspondence Address:
Jeetendra K Bajaj
Department of Anaesthesia and Intensive Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/astrocyte.astrocyte_82_17

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Context: Psoas compartment block via lumbar paravertebral approach has been compared with epidural block for postoperative pain relief following hip surgery. Settings and Design: This prospective, randomized study was conducted in the department of Anesthesia in a tertiary care hospital. Materials and Methods: This study was conducted on 60 patients undergoing unilateral hip surgery. They were randomly assigned to either psoas compartment (P) or epidural (E) group (30 in each group). A lumbar paravertebral (psoas compartment) or epidural catheter was placed before the start of surgery. A subarachnoid block using 0.5% hyperbaric bupivacaine and fentanyl was subsequently administered. After 2 h, a loading dose of 10 ml of 0.25% bupivacaine was given, and infusion of the same drug started at 5 ml/h in group P and 5 ml/h of 0.125% bupivacaine in group E using an elastomeric infusion pump. The patients were observed for 24 h and quality of pain relief with both the techniques was compared. Statistical Analysis: Categorical variables were analyzed with Chi-square test while continuous variables were analyzed with Student's t-test. Visual analog scale was expressed as median and was analyzed with Mann–Whitney test. A software program (SPSS 21) was used. P <0.05 was considered significant. Results: The mean duration of postoperative analgesia in the epidural group was 551.11 min compared to 427.25 min in the psoas compartment group (P > 0.05), which was not statistically significant. Mean pain scores at 4 and 8 h postoperatively were higher in the psoas compartment block resulting in greater rescue analgesic requirement in this group. Conclusions: Psoas compartment block can be considered an alternative in patients with relative contraindications to epidural block such as those on deep vein thrombosis prophylaxis with anticoagulants.

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