Comparison of the effects of epidural analgesia and local infiltrative analgesia methods on pain control and stress response in patients undergoing total knee arthroplasty

Abstract

Background: We compared the effects of epidural analgesia (EA) and local infiltrative analgesia (LIA) on pain control and stress response in the postoperative period in patients who underwent total knee arthroplasty. Methodology: The patients were divided into two groups as those who were administered EA (Group EA; n = 25) and those who were administered LIA (Group LIA; n = 26). Pain at rest and during movement at the incision site was evaluated in both groups with NRS. In order to evaluate the stress response; cortisol, insulin, ACTH and glucose levels in serum were measured. Results: All 51 patients included in the study were female, with a mean age of 63.4 ± 7.16 y and a body mass index of 32.4 ± 4.77 kg/m2 . There was no difference between the two groups in terms of NRS values, whether at rest or in moving. There was no statistically significant difference between the two groups in terms of serum cortisol, insulin, ACTH, and glucose levels. Conclusion: It was determined that both EA and LIA are similar effect in pain control at rest and movement, and both methods are effective in controlling the postoperative stress response in patients undergoing total knee arthroplasty. Abbreviations: ACTH-Adrenocorticotropic hormone; EA-epidural analgesia; LIA-local infiltrative analgesia; NRS-numeric rating scale; TKA-Total knee arthroplasty Key words: arthroplasty, epidural analgesia, local anesthesia, pain, stress response Citation: Çelik HK, Güzel N. Comparison of the effects of epidural analgesia and local infiltrative analgesia methods on pain control and stress response in patients undergoing total knee arthroplasty. Anaesth. pain intensive care 2023;27(3):379−388; DOI: 10.35975/apic.v27i3.2241 Received: Feb 12, 2023; Reviewed: March 11, 2023; Accepted: April 12, 2023