Journal
ANESTHESIA AND ANALGESIA
Volume 109, Issue 2, Pages 586-591Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1213/ane.0b013e3181a9db5d
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- NCRR NIH HHS [M01 RR000827, RR00082, M01 RR000082] Funding Source: Medline
- NIGMS NIH HHS [K23 GM077026-05, GM077026, K23 GM077026] Funding Source: Medline
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BACKGROUND: We previously reported that extending an oven-Light continuous posterior lumbar plexus nerve block to 4 days after hip arthroplasty provides clear benefits during the perineural infusion in the immediate postoperative period. However, it remains unknown whether the extended infusion improves subsequent health-related quality of life. METHODS: Patients undergoing hip arthroplasty received a posterior lumbar plexus perineural infusion of ropivacaine 0.2% from surgery until the following morning, at which time patients were randomized to continue either perineural ropivacaine (n = 24) or normal saline (n = 23) in a double-masked fashion. Patients were discharged with their catheter and a portable infusion pump, and catheters were removed on postoperative Day. 4. Health-related quality of life was measured using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index preoperatively and then at 7 days and 1, 2, 3, 6, and 12 mo after surgery. The WOMAC evaluates three dimensions of health-related quality of life, such as pain, stiffness, and physical functional disability (global score of 0-96, lower scores indicate lower levels of symptoms or physical disability). For inclusion in the primary analysis, we required a minimum of three of the six timepoints, including Day 7 and at least two of Months 3, 6, and 12. RESULTS: The two treatment groups had similar global WOMAC scores for the mean 0 area under the curve calculations (point estimate for the difference in mean area under the curve for the two groups [extended infusion group-overnight infusion group] = 0.8, 95% confidence interval: -5.3 to + 6.8 [-5.5% to + 7.1%]; P = 0.80) and at all individual timepoints (P > 0.05). CONCLUSIONS: This investigation found no evidence that extending an oven-right continuous posterior lumbar plexus nerve block to 4 days improves (or worsens) subsequent health-related quality of life between 7 days and 12 mo after hip arthroplasty. (Anesth Analg 2009;109:586-91)
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