The Influence of Epidural Versus General Anaesthesia on the Incidence of Thromboembolism After Total Hip Replacement

Modig, J.; Hjelmstedt, A; Sahlstedt, Bo; Maripuu, Enn; Saldeen, Tom

doi:10.1007/978-3-642-68139-4_15

Cited by 28 publications

(44 citation statements)

References 5 publications

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“…Epidural analgesia (EDA) lowers the incidence of postoperative thrombosis (Modig et al 1981) and attenuates the Factor VIII-complex response to surgical stress (Modig et al 1983, Bredbacka et al 1986). …”

Section: Discussionmentioning

confidence: 99%

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Activation of cascade systems by hip arthroplasty: No difference between fixation with and without cement

Bredbacka¹,

Andreen

Blombäck³

et al. 1987

Acta Orthopaedica Scandinavica

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No difference between fixation with and without cementThe acrylic bone cement has been regarded as a very potent activator of the hemostatic mechanisms. A battery of coagulation, fibrinolytic. and kallikrein variables were studied perioperatively in 21 patients undergoing hip arthroplasty with fixation of the prosthesis either with (Charnley) or without (HP-Garches) cement. Epidural analgesia was used and dextran 6 per cent as thromboprophylaxis. The HP-Garches procedure was shorter and caused less blood loss. No differences were found between the two surgical procedures regarding the activation of the cascade systems. The coagulation and fibrinolytic systems were activated early, but a week postoperatively the latter seems to predominate. A marked activation of the kallikrein system was apparent.Our study shows that despite thromboprophylaxis a marked activation of the coagulation, fibrinolytic, and kallikrein systems occurs in relation to hip arthroplasty irrespective of the use or nonuse of cement and irrespective of the volume of blood loss during surgery. It may be the reaming of the bone marrow that initiates the activation of the cascade systems.

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Section: Discussionmentioning

confidence: 99%

“…Furthermore, hip replacement is followed by a high incidence of postoperative deep venous thrombosis unless prophylactic measures are taken (Modig et al 1981, Thorburn et al 1980). …”

Section: Introductionmentioning

confidence: 99%

Activation of cascade systems by hip arthroplasty: No difference between fixation with and without cement

Bredbacka¹,

Andreen

Blombäck³

et al. 1987

Acta Orthopaedica Scandinavica

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“…14 For major orthopedic surgery such as total hip or knee arthroplasty, regional anesthesia has been shown to have several advantages over general anesthesia. 15,16,17 In a controlled study comparing CSE, spinal anesthesia and epidural block for orthopedic surgery, it was shown that spinal anesthesia and CSE were superior to epidural block. 17 CSA is a well-established technique that has been used successfully in many surgical procedures.…”

mentioning

confidence: 99%

Study -“Comparative Study of Combined Spinal Epidural Versus Epidural Anaesthesia in Lower Limb Surgeries And Lower Abdominal Surgeries ”

Sundar¹,

Mundwadkar²

2017

IOSR JDMS

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“…Epidural analgesia has the ability to maintain continuous analgesia after placement of an epidural catheter with the analgesic drug thus making it suitable for continuous postoperative pain relief and early ambulation. [1][2][3] For major orthopaedic surgery such as total hip and knee arthroplasty regional anaesthesia is believed to have certain advantages over general anaesthesia. [3][4][5] The two most common regional techniques are spinal and epidural anaesthesia.…”

mentioning

confidence: 99%

“…[1][2][3] For major orthopaedic surgery such as total hip and knee arthroplasty regional anaesthesia is believed to have certain advantages over general anaesthesia. [3][4][5] The two most common regional techniques are spinal and epidural anaesthesia. Spinal block is a simple method, which requires a small dose of local anaesthetic to establish an intense and reliable block quickly.…”

mentioning

confidence: 99%

A Comparative Study Between Ropivacaine and Bupivacaine Along With Fentanyl as an Adjuvant to Both to Observe the Efficacy of Postoperative Epidural Analgesia

Debnath¹,

Chakrabarti²,

Majumdar³

2016

jemds

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BACKGROUNDEpidural analgesia is considered by many as 'gold standard' of analgesic technique for postoperative analgesia after lower limb as well as abdominal surgeries. Epidural analgesia has the ability to maintain continuous analgesia after placement of an epidural catheter with the analgesic drug thus making it suitable for continuous postoperative pain relief and early ambulation. Epidural opiates in combination with local anaesthetics are commonly used for postoperative analgesia with several lines of evidence indicate that opiates administered through the epidural route are safe with proven benefits such as good pain relief, less pain during movement, better mental status, fewer complication. Even though bupivacaine, the ideal local anaesthetic and has similar pharmacological profile with ropivacaine, but which cardiac safety margin is lower than ropivacaine due to its Senantiomer.

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The Influence of Epidural Versus General Anaesthesia on the Incidence of Thromboembolism After Total Hip Replacement

Cited by 28 publications

References 5 publications

Activation of cascade systems by hip arthroplasty: No difference between fixation with and without cement

Activation of cascade systems by hip arthroplasty: No difference between fixation with and without cement

Study -“Comparative Study of Combined Spinal Epidural Versus Epidural Anaesthesia in Lower Limb Surgeries And Lower Abdominal Surgeries ”

A Comparative Study Between Ropivacaine and Bupivacaine Along With Fentanyl as an Adjuvant to Both to Observe the Efficacy of Postoperative Epidural Analgesia

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