Can Ropivacaïn 1% replace morphine intrathecal in total hip replacement

In recent past we had a few patients (4) who were allergic to morphine. That is
why we gave them a femoral block with ropivacaïne 1% 30mL after a total hip
repair. Later information learned that it was a succesful treatment with very
good results on postoperative pain. Besides that, it was reported that there
were less side effects such as itching, nausea and vomiting. Patients were very
satisfied. For this we would like to investigate whether the method of
postoperative pain treatment could be changed. In this investigation we compare
two groups of 10 patients. One group receive anesthesia as usual in our
hospital naamely spinal anesthesia with 17,5 mg bupivacaïn with morphine 100
micrograms intrathecal. The other group will receive spinal anesthesia 17,5 mg
bupivacaine and a femoral block with 300 mg ropivacaïne,

Objective is to compare the two groups whether the pain scores are at least the
same. Also will be noticed if the incidence of side effects of morphine
intrathecal are less (e.g. itching, nausea and/ or vomiting and urine
retention, although this is not an iten because the patients get a urine
catheter) Patients satisfaction will also be noted. If the results are positive
for the femoral block we will change our practice.

Two groups patients seen on the preoperative poli will be asked to participate
in this investigation. The assignment of treatment will be made in the holding.
The patient will not know in which group he or she is assigned. (single
blinded) Comparisons will be made of the mean VAS of the same time (t-test)The
incidence of itching, nausea and/ or vomiting will be noted. Also the first
moment of patients request to extra pain killers is noted. We think that 10
patients per group is enough, because we are interested in clinically important
differences. If larger numbers ar needed it is more a academic difference.

None besides the operation itself.