Compared with bupivacaine, lidocaine had a more favorable complication profile when used for neuraxial anesthesia in patients undergoing total hip arthroplasty, according to presented results.
“Many people are moving toward regional anesthesia, such as neuraxial anesthesia (NA) [for THA],” Robert Scott Roundy, BS, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting. “However, what type of anesthetic to use in NA is still being debated. One of the worst complications of NA is transient neurological symptoms (TNS) or postoperative pain in the buttocks or extremities
Roundy and colleagues from Emory University performed a prospective, double-blinded randomized controlled trial that compared outcomes of 54 patients who received bupivacaine and 51 patients who received lidocaine for NA during THA. According to the study abstract, outcomes included TNS, time to normal sensation, urinary retention, ambulation and length of stay.
Overall, Roundy and colleagues found no differences in time to normal sensation, urinary retention, ambulation or length of stay between the groups. They noted patients in 13 patients (24%) in the bupivacaine group had urinary incontinence compared with no patients in the lidocaine group. Additionally, seven patients (13%) in the bupivacaine group reported having difficulty with urination or defecation compared with no patients in the lidocaine group.
“These data support the use of lidocaine as part of NA in total hips.
He noted that with increasing rates of outpatient surgery, as well as decreasing OR times and costs of lidocaine, this treatment may have further benefits that were not captured in this study.
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