Summary

The instillation of a physiological saline solution with epinephrine and lidocaine prior to the surgical treatment of GTPS is effective in reducing surgical times, likely due to a reduction in intraoperative bleeding.

Abstract

Introduction

Greater Trochanteric Pain Syndrome (GTPS) is a multifactorial clinical condition affecting the lateral area of the hip. Although conservative treatment shows good results, some patients may still require surgical bursectomy, which can be performed either openly or endoscopically. One of the main technical difficulties of the endoscopic procedure is intraoperative bleeding, which can hinder the medical team's vision and increase the surgical time for endoscopic treatment of GTPS.
The aim of the current study is to describe the efficacy of a preoperative instillation of vasoconstrictors and local anaesthetics before endoscopy in the improvement of surgical timings through the reduction of intraoperative bleeding.

Materials And Methods

This study was designed as a retrospective analysis of a prospective single-centre patient database. All procedures were performed by the same medical and nursing team. At a certain point, the surgical team decided to introduce the preoperative instillation of physiological saline solution with epinephrine and lidocaine in order to decrease intraoperative bleeding in the usual surgical procedure. Accordingly, the cohort was retrospectively divided based on the presence or absence of such procedure modification. Surgical time was measured in each procedure and compared between the two groups.

Results

A total of 139 hips from 139 patients were included in the analysis. 102 patients were included in the instillation group versus 37 in the control group. The surgical time was significantly shorter in the instillation group than in the control group, with an average (standard deviation) of 52.01 (14.71) and 72.30 (11.70) minutes, respectively (p < 0.001).

Conclusion

The instillation of a physiological saline solution with epinephrine and lidocaine prior to the surgical treatment of GTPS is effective in reducing surgical times, likely due to a reduction in intraoperative bleeding. Future research should focus on more direct outcomes such as intraoperative blood loss and the influence of different instillation protocols.