Source: DGNews  |  Posted 5 years ago

By John Otrompke

CHICAGO, I.L. -- March 28, 2006 -- The use of propofol as an anesthetic in patients with hip dislocation associated with total hip arthroplasty saves time, reduces complications and has fewer adverse effects compared to the use of morphine and midazolam, according to a small study presented in a poster session here at the 2006 annual meeting of the American Academy of Orthopedic Surgeons (AAOS).

The results from the prospective, randomized trial contribute to the arguments made for the use of propofol, which has been criticized by anesthesiology organizations who say its use leads to increased patient injuries.

James A. Loging, MD, orthopedic surgery resident, Greenville Hospital System, University Medical Center, Greenville, South Carolina, United States, and colleagues randomized 36 patients who needed surgical treatment for a dislocated hip following total hip arthroplasty into two general anesthesia groups: one received propofol and one received morphine plus midazolam.

Time to alertness following surgery was much shorter for propofol patients than for the morphine/midazolam group (9 minutes vs. 73 minutes, P =.0013). Time to reduce the dislocated hip was also shorter in the propofol group (5 minutes vs. 13), the poster said.

Physician rated ease of reduction on a scale of 0 to 10 (0=unable to reduce, 10=easily reducible) was better in the propofol group (8.6 vs. 6.6, P =.0013).

Pain scores and quality of sedation were not different between the two treatment groups (P >.05).

Complications in the morphine group included nausea, vomiting, decreased blood pressure, and/or mild oversedation. Complications in the propofol group included mild oversedation, defined as decreased oxygen saturation of >10%.

Propofol appeared to make reduction of total hip dislocations quicker and easier, with a faster recovery from anesthesia when compared to sedation with morphine and midazolam, the researchers concluded.

[Presentation title: Prospective, Randomized Study of Morphine/Midazolam Versus Propofol for THA Dislocation Reductions. Poster P064]