Multimodal analgesia with anapiron, nonsteriod anti-inflammatory drugs, local infiltrative anesthesia, and pregabalin in case of primary total hip arthroplasty

Authors

  • Stanislav Bondarenko Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0003-2463-5919
  • Volodymyr Filipenko Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0001-5698-2726
  • Mykola Lyzogub Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0003-4776-1635
  • Ahmed Badnaoui Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0002-8498-4558
  • Artur Moysey Military Medical Clinical Center of the Southern Region, Odessa. Ukraine, Ukraine
  • Kseniia Lyzogub Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine

DOI:

https://doi.org/10.15674/0030-59872018311-15

Keywords:

multimodal analgesia, arthroplasty, hip joint

Abstract

Objective: to evaluate the effectiveness of anesthesia, side effects and time to activation from the bed patients with hip joint arthritis of the IV stage after total hip arthroplasty using multimodal analgesia with Anapiron, nonsteriod anti-inflammatory drugs, local infiltrative anesthesia, and pregabalin compare to standard opioid analgetics.

Methods: A prospective, randomized comparative study included 100 patients (age 51 to 72 years) with hip arthritis of the IV stage and different etiology after primary total hip arthroplasty. In the study group (50 patients) a protocol of multimodal analgesia was used: pregabalin 150 mg in the evening before surgery, then 150 mg twice a day for 5 days, intraoperative local infiltrative anesthesia of the hip joint region with a mixture (bupivacaine 0.25 % 40 ml, epinephrine 0.3 ml, ketorolac 30 mg, dexamethasone 4 mg); after the surgery — Anapirone 1 g, 6 times for 2 days; parecoxib 20 mg, 2 times during the day, then — dexketoprofen 50 mg in case of pain more than 3 points by VAS. In 50 patients of the control group after the surgery have been using opioid drugs parenterally and dexketoprofen 50 mg/day during 2–3 days. The pain syndrome was assessed according to VAS on days 1, 2 and 3 after the operation, also side effects and time to their-self rising from the bed.

Results: in both groups effective anesthesia was achieved without significant difference in the parameter «pain syndrome». Side effects (nausea, vomiting, and dizziness) in the study group are much less common than in the control group. Patients of the control group rose their-self from the bed one day later than in the study group (p = 0.047).

Conclusions: multimodal analgesia with Anapiron, nonsteriod anti-inflammatory drugs, local infiltrative anesthesia, and pregabalin in case of primary total hip arthroplasty allowed us to obtain effective analgesia, decrease the amount of side effects and promote early activation of patients compare to standard regimes with opioid analgetics.

Author Biographies

Stanislav Bondarenko, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

PhD in Traumatology and Orthopaedics

Volodymyr Filipenko, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, Prof. in Traumatology and Orthopaedics

Mykola Lyzogub, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

PhD

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How to Cite

Bondarenko, S., Filipenko, V., Lyzogub, M., Badnaoui, A., Moysey, A., & Lyzogub, K. (2023). Multimodal analgesia with anapiron, nonsteriod anti-inflammatory drugs, local infiltrative anesthesia, and pregabalin in case of primary total hip arthroplasty. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (3), 11–15. https://doi.org/10.15674/0030-59872018311-15

Issue

No. 3 (2018)

Section

ORIGINAL ARTICLES

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Copyright (c) 2018 Stanislav Bondarenko, Volodymyr Filipenko, Mykola Lyzogub, Ahmed Badnaoui, Artur Moysey, Kseniia Lyzogub

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