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EPIDURAL ROPIVACAINE 0.2% VERSUS 0.1% IN POSTOPERATIVE ELDERLY PATIENT AFTER TOTAL KNEE ARTHROPLASTY
Author(s): ,
Gonçalves, D.*
Affiliations:
Centro Hospitalar de Leiria, Anaesthesiology, Leiria, Portugal
,
Fonseca, R.
Affiliations:
Centro Hospitalar de Leiria, Anaesthesiology, Leiria, Portugal
,
Lavado, J.
Affiliations:
Centro Hospitalar de Leiria, Anaesthesiology, Leiria, Portugal
,
Campos, A.
Affiliations:
Centro Hospitalar de Leiria, Anaesthesiology, Leiria, Portugal
,
Dixe, M.
Affiliations:
Instituto Politécnico de Leiria, Escola Superior de Saúde de Leiria, Leiria, Portugal
Valente, E.
Affiliations:
Centro Hospitalar de Leiria, Anaesthesiology, Leiria, Portugal
ESRA Academy. Gonçalves D. Sep 13, 2017; 190982; 363 Topic: Knee Surgery
Décia Gonçalves
Décia Gonçalves

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Abstract
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Background and Aims:

Postoperative pain control after total knee arthroplasty (TKA) is a concern for Anesthesiologists, especially in the elderly population, where physiological changes may determine different patterns of pain and side effects.

This study compared the analgesic efficacy and safety of continuous infusion epidural analgesia (CIEA) with ropivacaine 0,1% and 0,2% combined with morphine and droperidol after TKA in the elderly patient. We intended to identify the option that guarantees greater analgesic comfort without compromising patient safety.

Methods:

After the approval of local Ethics Committee, we conducted a retrospective review of 104 patients older than 65 years who were submitted to TKA under spinal anesthesia and postoperative CIEA with: ropivacaine 0,1%,morphine 20mcg/mL and droperidol 10mcg/mL (group A,n=48) versus ropivacaine 0,2%,morphine 20mcg/mL and droperidol 10mcg/mL (group B,n=56).

Demographic characteristics, American Society of Anesthesiologists physical status, numeric pain rating scale in rest, movement, coughing and surgical wound and analgesia related side effects were all analyzed, during 48-hour postoperative period.

Results:

The mean pain values referred in the three categories during the first 48 hours were inferior in the group B  (statistically significant at rest and movement: p=0,008 and p=0,011, respectively).

The incidence of side effects were not significantly different between the two groups.

The demographic characteristics and ASA classification did not significantly influence this results.

Conclusions:

This results sugest that CIEA of ropivacaine 0,2%, morphine (20 mcg/mL)  and droperidol (10 mcg/mL) promotes better analgesic control after TKA in elderly patients, than ropivacaine 0,1%, without significantly increase of related side effects.

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