UNLABELLED:The study was carried out to compare analgesia, the side-effects incidence and the need for analgetics when you use the continuous iliofascial block (CIFB) versus epidural analgesia (EA) after the total hip joint endoprosthesis (THJEP). 60 patients undergoing planned THJEP under spinal anaesthesia were included in a randomized controlled study. The day before the surgery all patients were divided into 2 groups (30 people each). In the 1st group postoperative analgesia carried out on the basis of the EA, and in the 2nd group - CIFB. All patients received balanced analgesia with nonopioid analgesics, and in case of pain syndrome - tramadol injections. In the 1-st group the value of the visual-analogue scale - VAS (0-100mm) 6 h after the operation was significantly lower at rest and in motion. The maximum average value of VAS in motion was 2.3 +/- 2, 1 mm in EA group and 3.2 +/- 2.6 mm in CIFB group. Frequency of tramadol use in 1-st and 2-nd groups was 6.9% and 41.4%, and of nausea - 34,5% and 6.9%, respectively. Patient analgesia satisfaction was higher in the 2nd group.CONCLUSION:Extended IFB provides a good level of analgesia in patients after THJEP. Prolonged EA exceeds CIFB in analgesia, but is accompanied by a greater frequency of postoperative nausea occurrence.

Objective: to evaluate the efficiency and safety of various perioperative analgesia modes during total hip joint replacement (THR). Subjects and methods. A randomized controlled trial enrolled 90 patients who were divided into 3 groups according to the choice of a perioperative analgesia mode on day 1: general sevofluorane anesthesia, by switching to intravenous patient-controlled analgesia with fentanyl (PCA, GA group), a combination of general and spinal bupiva-caine anesthesia, by switching to PCA with fentanyl (SA group), a combination of general and epidural ropivacaine anesthesia with continuous postoperative epidural ropivacaine infusion (EA group). All the patients received non-opi-oid analgesics after surgery. Results. Prolonged epidural block ensures better postoperative analgesia at rest and during mobilization and a less need for opioids than other analgesia modes (p<0.05). With neuroaxial block, the preoperative need for sympatomimetics is much higher than that in the GA group (p<0.05). There is also a trend toward a higher incidence of cardiac arrhythmias and postoperative nausea and vomiting in the SA and EA groups. There are no differences in the frequency of hemotransfusion and postoperative complications and the length of hospital stay. Conclusion. Prolonged epidural block provides excellent perioperative analgesia during THR, but the risk-benefit ratio needs to be carefully assessed when an analgesia mode is chosen.