The effects of pre-emptive analgesia with bupivacaine on acute post-laminectomy pain
- First Online:
- 140 Downloads
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.
KeywordsPre-emptive analgesia Bupivacaine Pain Lumbar laminectomy
- 9.Jayr C, Mollié A, Bourgain JL et al (1998) Postoperative pulmonary complications: general anesthesia with postoperative parenteral morphine compared with epidural analgesia. Surgery 104:57–63Google Scholar
- 18.Ready LB (1994) Acute postoperative pain. In: Bonica JJ (ed) Anesthesia, vol I. Churchill Livingstone, New York, pp 2327–2335Google Scholar