ORIGINAL ARTICLES

Door to relocation time for dislocated hip prosthesis: multicentre comparison of emergency department procedural sedation versus theatre-based general anaesthesia

J Gagg¹, L Jones¹, G Shingler², N Bothma³, H Simpkins⁴, S Gill⁵, J Benger⁶, G Lloyd¹

¹ Emergency Department, Royal Devon and Exeter Hospital, Exeter, UK
² Emergency Department, Frenchay Hospital, Bristol, UK
³ Emergency Department, Derriford Hospital, Plymouth, UK
⁴ Emergency Department, Musgrove Park Hospital, Taunton, UK
⁵ Emergency Department, Bristol Royal Infirmary, Bristol, UK
⁶ Academic Department of Emergency Care, University Hospitals Bristol NHS Foundation Trust, Bristol, UK

Correspondence to:
Dr G Lloyd, Emergency Department, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter EX2 5DW, UK; gavin.lloyd{at}rdeft.nhs.uk

Background: Dislocation of a hip prosthesis is a painful event which has an incidence of 4% for primary total hip arthroplasty. Relocation is traditionally performed under general anaesthesia in the operating theatre, but relocation using sedation in the emergency department (ED) has been reported, with a limited success rate of 62%. A study was undertaken to compare door to relocation times for ED sedation and theatre general anaesthesia.

Methods: The notes of all patients attending five centres in the south west of England with prosthetic hip dislocation over a 12-month period between 2005 and 2006 were retrospectively reviewed using standardised data collection forms.

Results: Successful ED reduction was significantly quicker than failed ED reduction and theatre-based general anaesthesia (2 h 21 min vs 8 h 32 min; p<0.001). No statistical difference was found between failed ED reduction and theatre general anaesthesia.

Conclusions: Reduction of dislocated hip prostheses in the ED saves nearly 6 h compared with theatre-based general anaesthesia and is therefore advocated.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Primary survey

Darren Walter
Emerg. Med. J. 2009 26: 1. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Mathieu, N, Jones, L, Harris, A, Hudson, A, McLauchlan, C, Riou, P, Lloyd, G (2009). Is propofol a safe and effective sedative for relocating hip prostheses?. Emerg. Med. J. 26: 37-38 [Abstract] [Full Text]