Posterior lumbar plexus block provides effective analgesia for total hip arthroplasty, reducing intra- and postoperative opioid requirements. Moreover, blood loss during and after the procedure is diminished. Epidural anesthetic distribution should be anticipated in a minority of cases.

Clonidine in brachial plexus block does not improve postoperative analgesia when mixed with a long-lasting anesthetic. Nevertheless, with or without clonidine, bupivacaine in interscalene block provides a long-lasting analgesia of approximately 15 h.

There is a short-term benefit during the first few postoperative hours in using a single shot "3-in-1" femoral nerve block to complement general anaesthesia for elective hip surgery.

We conclude that after total hip replacement, administration of intrathecal nalbuphine resulted in a significantly faster onset of pain relief and shorter duration of analgesia than intrathecal morphine.

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We evaluated the effect of epinephrine on the duration of analgesia of 20 mL ropivacaine 0.5% or 0.2% injected in femoral three-in-one block for pain relief after total knee replacement. Our results show that epinephrine does not alter the duration of analgesia of the two solutions investigated.

SummaryThis retrospective study compared continuous spinal anaesthesia with continuous epidural anaesthesia for lower limb orthopaedic surgery in the elderly. The anaesthetic records of 457 patients who received continuous spinal anaesthesia and 274 who received continuous epidural anaesthesia over a 5-year period were analysed. The patients who had continuous spinal anaesthesia were at a higher anaesthetic risk (ASA 3-4, 76% as compared with 37%, p < 0.001), but the incidence of failures was significantly lower (1.7%, as compared with 9%, p < 0.001) andfewer patients showed a decrease in mean arterial pressure of more than30% (&YO, ascomparedwith65%,p < 0.001)and(or)receivedvasopressors(65%,ascomparedwith 77%,p < 0.01). Ourdata show continuous spinal anaesthesia to be more reliable and to provide better cardiovascular stability.