The effects of pre-emptive analgesia with bupivacaine on acute post-laminectomy pain
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- Mordeniz, C., Torun, F., Soran, A.F. et al. Arch Orthop Trauma Surg (2010) 130: 205. doi:10.1007/s00402-009-0961-2
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This is a prospective, non-randomized, hospital-based, case-controlled, clinical trial to assess the efficacy of perineural infiltration with bupivacaine at the related neural root for acute pain relief after lumbar laminectomy.
Fifty-one patients undergoing unilateral one spinal level (lumbar 4) hemi-partial laminectomy were included in the study. In 22 of the patients (Group 2), bupivacaine was infiltrated onto the neural root immediately after the exposure; the 29 patients in the control group (Group 1) were not infiltrated. All patients were monitored post-operatively regarding pain determination using a visual analog scale, and the exact time of analgesic requirement during the first post-operative day was noted. Total analgesic dose given during the first post-operative day was also recorded.
The patients who received bupivacaine infiltration intraoperatively onto the neural root (Group 2) had a statistically significantly longer time to first analgesia request (P < 0.001) and also required significantly less analgesic when compared to the control group (Group 1) (P < 0.001). Perineural bupivacaine infiltration extended the early post-operative analgesic period. While the pain was not completely suppressed, the bupivacaine infiltration helped to manage the post-operative pain more effectively.
Our data suggests that pre-emptive analgesia via perineural infiltration of bupivacaine is a simple, and effective method for post-operative acute pain relief.