Total Hip Replacement
Conditions
Keywords
total hip replacement, pain treatment
Brief summary
There are several treatments for postoperative pain after Hip Replacement Surgery. However, some require an intravenous line which may interfere with rehabilitation after surgery. This study aims to evaluate which method of pain treatment is best after Hip Replacement Surgery. Patients will either receive pain treatment at surgery, continuous intravenous pain treatment, or both. In the first two days after surgery, patients will frequently be asked to rate their pain, and use of other pain medication will be monitored.
Detailed description
This is a three-group randomized placebo-controlled double blind trial to assess which postoperative analgesia is best after total hip replacement. The conventional analgesia includes both intrathecal morphine at surgery and Patient Controlled Analgesia (PCA) with morphine in the first 48 hours after surgery. This will be compared with two experimental groups which will receive either intrathecal morphine and PCA with placebo or intrathecal placebo and PCA with morphine. Escape medication with intramuscular morphine is available in all groups. A total of 120 patients will be randomized. VAS- score at rest and with movement will be recorded every three hours for the first 48 hours after surgery, as well as PCA-bolussum and Morphine IM.
Interventions
DRUGIntrathecal morphine at surgery, 0.1mg and placebo
DRUGPatient Controlled Analgesia with iv morphine and placebo
DRUGintrathecal morphine AND patient controlled analgesia with iv morphine
Sponsors
Rijnstate Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE
Eligibility
Sex/Gender
ALL
Age
30 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Patients accepted for fast-track total hip replacement, i.e.ASA 3 or lower
Exclusion criteria
* Not able to speak dutch * communication problems * dementia * mental retardation
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| VAS-score for pain at movement and at rest every three hours | — |
| PCA-bolus-sum every three-hour period | — |
| Morphine-IM rescue dose every three-hour period | — |
Secondary
| Measure | Time frame |
|---|---|
| quality of physical training | — |
| patient satisfaction each 24 hours | — |
| urine retention every three hours | — |
| PONV every three hours | — |
| iv-morphine dose needed to attain VAS-score under 40 mm | — |
| itching every three hours | — |
| decrease in saturation every three hours | — |
Outcome results
None listed