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Pain Management Following Total Hip Arthroplasty Study
Patients undergoing total hip arthroplasty will be randomized to one of two groups. Group 1 will consist of a standard post-operative epidural infusion of 0.1% bupivacaine, 5 mL/hr continuous infusion with 1 mL every 15 minutes as a bolus option. Group 2 will consist of a programmed intermittent epidural bolus of 5 mL every hour with 1 mL every 15 minutes as a bolus option. Both groups of patients will be allowed to have oral opioids and adjuvants following their surgery.
In order to participate you must meet the following criteria:
- Have total hip replacement surgery scheduled.
- Are between the ages of 18 and 89.
You will be excluded from the study if any of the following criteria apply to you:
- Have a history of prior lumbar spine surgery.
- Have a history of bleeding disorder or current use of anticoagulant/antiplatelet agents.
Have a history of opioid tolerance defined as the following:
- At least 60 mg of oral morphine/daily
- At least 25 mcg transdermal fentanyl/hour
- At least 30 mg of oral oxycodone daily
- At least 8 mg oral hydromorphone daily
- At least 25 mg oral oxymorphone daily
- An equianalgesic dose of another opioid daily for a week or longer
- Are allergic to or have a documented reaction to bupivacaine or amide local anesthetics.
- Have a disability or impairment such that using a patient-controlled bolus would not be possible.
- Have surgeon-specified perioperative procedures that precludes the current study’s protocol.
This is a partial list of inclusion and exclusion criteria.