C-reactive protein level in plasma and drainage blood depends on the method of anaesthesia and post-operative analgesia after hip surgery.

BACKGROUND: Serum C-reactive protein (CRP) detects the inflammatory response to surgical trauma in hip surgery. It corresponds to the type of surgery, with a higher level of CRP being found in surgery techniques with greater tissue damage. The aim of our study was to analyze the CRP level in serum and drainage blood after hip surgery in patients with coxarthrosis depending on the method of anaesthesia and post-operative analgesia.

METHODS: 65 patients, 58 ± 12 years old, were included in the study. All patients underwent hip replacement surgery due to coxarthrosis. Serum CRP was measured before surgery and on the 1st, 3rd and 7th postoperative days. The CRP level in drainage blood was detected on the 1st, 2nd and 3rd postoperative days. Patients were divided into six groups according to the techniques of intraoperative anaesthesia and postoperative analgesia.

RESULTS: Before surgery, plasma CRP did not differ significantly among the groups. The smallest increase in plasma CRP was found in patients operated on under regional anaesthesia compared with those operated on under general anaesthesia. Postoperatively, the plasma CRP level was higher in patients treated with the systemic administration of opioids+NSAID, than in patients treated with regional analgesia. A significant increase in CRP levels in drainage blood for three days postoperatively was seen in all groups. In patients operated on under general anaesthesia and receiving systemic opioids+NSAID postoperatively, CRP in drainage blood was higher in comparison with those operated on under regional anaesthesia and treated with regional methods of postoperative analgesia.

CONCLUSION: C-reactive protein levels in plasma and drainage blood depends on the method of anaesthesia and postoperative analgesia after hip surgery. Regional anaesthesia/analgesia methods limit one's inflammatory response to surgical trauma detected by CRP.