The Effects of the Type of Neuroaxial Block on Postoperative Pain after Total HIP Replacement Surgery: Spinal vs. Epidural Anaesthesia

In this study, we aimed to investigate whether the type of anaesthesia affected postoperative pain, or not, when total hip replacement surgery was performed under spinal or epidural anaesthesia. The patients were randomly assigned to two groups. In Group E, surgery was performed under epidural anaesthesia, and in Group S under spinal anaesthesia. Patient controlled epidural analgesia with morphine and bupivacaine was used for postoperative analgesia. Visual analog scale was recorded at the rest and during movement. Postoperative analgesic consumption, patient satisfaction and complications were also recorded. Visual analog scale scores were significantly lower in Group S at the rest and during movement (p<0.05). Postoperative analgesic consumption was lower in Group S (p=0.001). There was no difference with regard to postoperative complications. The patients were more satisfied with their analgesic treatment in Group S (83%) than those of Group E (54%) (p=0.037). In conclusion, we observed that spinal anesthesia produced more satisfactory postoperative analgesia after total hip replacement surgery. We believe that this beneficial effect may be related to complete blockade of nociceptive afferent signals by the spinal anaesthesia.