Advantages and Disadvantages of the Prolonged Epidural or Peripheral Nerve Blockade after Endoprosthesis Replacement of Large Joints of Lower Limbs in Cancer Patients

R.V. Garjaev

FGBU «Russian Cancer Research Center. n.a. N.N. Blokhin», Moscow

For citation: Garjaev RV. Advantages and Disadvantages of the Prolonged Epidural or Peripheral Nerve Blockade after Endoprosthesis Replacement of Large Joints of Lower Limbs in Cancer Patients. Intensive Care Herald. 2016;2:61–69.


 Тhe aim of the study. During the prospective non-randomized study 404 patients were operated due to bone tumors in the volume of tumor removal with consequent defect replacement with mega-prosthesis of the hip (n = 65), knee (n = 300), ankle (n = 14) joints and total prosthesis of femur (n = 25). Materials and methods.The combination of spinal or superficial general anesthesia with epidural (n = 122) or conduction (n = 282) analgesia was used for pain relief. The regional pain relief after surgery continued for 3–5 days. The level of pain, need for additional pain relief, frequency of failures and complications were studied as per the digit rating scale. The following nonparametric analysis methods were used for statistical processing: U-Mann—Whitney test or Fisher’s exact test. Results. The level of pain after surgery was not statistically different in the groups with epidural or conduction pain relief. With post-surgery conduction pain relief compared to epidural analgesia arterial hypotension (4.9 versus 10.7 %, p = 0.036, 95 % CI: 0.19–0.96) and urinary retention (0.4 versus 4.1 %, p = 0.012, 95 % CI: 0.01–0.72) developed more rare. The conduction analgesia turned out to be more complicated from technical point of view. Conclusions. Given the similar efficiency of pain relief the conduction analgesia compared to epidural one has been followed by the less number of the side effects.

Keywords: prolonged epidural analgesia, prolonged conduction analgesia, postoperative pain relief

Received: 20.04.2016


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