Epidural Versus General Anaesthesia for Total Hip Arthroplasty in Elderly Patients

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Abstract
Sixty elderly patients were given at random either epidural analgesia with bupivacaine 0.75% or general anaesthesia with thiopentone, fentanyl, pancuronium, N2O/O2 for total hip replacement. Preoperatively the patients were of equal physical status with normal and similar laboratory values. All patients were mentally normal for their age. On the 1st postoperative day, the general anaesthesia group had a signilicantly lower PaO2 than the epidural group (p2 in the general anaesthesia group was significantly lower than the preoperative value on the 1st and 3rd postoperative days (P2 might have contributed to this death. Two patients in the epidural group had symptoms of pulmonary embolism postoperatively. Thus elderly patients appear to do better after hip replacement with less deterioration of cerebral and pulmonary functions when given epidural analgesia than when surgery is performed under general anaesthesia. These patients should therefore be offered epidural analgesia whenever possible.