General or Regional Anesthesia for Hip Surgery

Not Applicable

Completed

Brief Summary: The purpose of this study is to determine whether general anaesthesia or regional anaesthesia is best for patients undergoing Total Hip Arthroplasty.

Detailed Description: A randomized controlled trial (RCT) with a follow up time of 48 hrs. Patients scheduled for primary Total Hip Arthroplasty. A total of 120 patients randomly assigned to one of the two alternatives (general anaesthesia (GA) or regional anaesthesia (RA)).

General anaesthesia compared to intrathecal anaesthesia will give shorter length of hospital stay (LOS) for patients undergoing total hip arthroplasty (THA).

Primary endpoint:

LOS.

Secondary endpoints:

Postoperative pain? Postoperative orthostatic function (dizziness) Time until the patient meets the discharge criteria from PACU How many patients will need at least one urinary bladder catheterisation

Recruitment & Eligibility

Inclusion Criteria

patients with osteoarthritis scheduled for surgery

patients that will require THA
patients over 45 yrs and under 85 yrs.
patients that understand the given information and are willing to participate in this study
patients who have signed the informed consent document.
patients belonging to ASA class I-III.

Exclusion Criteria

prior surgery to the same hip
patients with a history of stroke, neurological or psychiatric disease that potentially could affect the perception of pain
obesity (BMI > 35)
active or suspected infection
patients taking opioids or steroids
patients suffering from rheumatoid arthritis or an immunological depression
patients who are allergic to any of the drugs being used in this study

Arm && Interventions

Group	Intervention	Description
GA-arm, remifentanil	GA-arm, remifentanil	GA-arm: patients in this arm will receive general anaesthesia consisting of Target Controlled Infusion (TCI) of remifentanil and propofol
RA-arm	RA-arm	RA-arm: the patients in this arm will receive intrathecal anaesthesia consisting of bupivacaine 15 mg

Primary Outcome Measures

Name	Time	Method
Length of Hospital Stay	Up to 4 days after surgery	Time from the end of surgery until the patients meets the discharge criteria will be evaluated. Discharge criteria: able to get in and out of bed, Able to get dressed. Able to sit down in a chair and get up again. Able to walk 50 meters wit/without crutches. Able to flex knee 70 degrees. Able to walk stairs. Pain manageable with oral analgesics. Acceptance to be discharged

Secondary Outcome Measures

Name	Time	Method
Post Operative Pain	from end of surgey until 48 hrs later	Pain will be monitored using a Visual Analogue Scale. Pain will be monitored with the patient in four different positions. VAS 100 mm used for assessment of pain (0 = no pain, 100 = worst imaginable pain). At each time and position the median VAS-pain score was reported (generally the distribution of pain scores are not normally distributed and hence median value was used)