Intraoperative epidural application of steroid and local anaesthetic agent following lumbar discectomy: A prospective double blinded randomized controlled trial

Abstract Background Postoperative pain management following lumbar discectomy is a key part of the procedure and various postoperative pain protocols including a wide range of agents are being used in daily practice worldwide. The aim of this study is to investigate the effect of intraoperative epid...

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Bibliographic Details
Published in:Journal of clinical orthopaedics and trauma 2019-10, Vol.10 (Suppl 1), p.S143-S146
Main Authors: Samoladas, Efthimios, Kapinas, Arion, Papadopoulos, Dimitrios V, Gkiatas, Ioannis, Papastefanou, Sotirios, Gelalis, Ioannis D
Format: Article
Language:English
Subjects:
Anaesthetics
Complications
Discectomy
Orthopedics
Pain management
SPINE
Steroids
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Summary:Abstract Background Postoperative pain management following lumbar discectomy is a key part of the procedure and various postoperative pain protocols including a wide range of agents are being used in daily practice worldwide. The aim of this study is to investigate the effect of intraoperative epidural infiltration of local anaesthetic and steroid compared with placebo (normal saline) following microscopic lumbar discectomy. Methods Sixty patients undergoing lumbar discectomy were randomized to intraoperative infiltration of 3 mg betamethoasone acetate and 18 mg ropivacaine (Group A) or normal saline (Group B). Infiltration was performed after discectomy and decompression and immediately prior to incision closure. Postoperatively a standard protocol of intravenous acetaminophen administration and physiotherapy was followed. Additional analgesia with tramadol was given only in patients who required further pain management. Postoperative pain was evaluated using VAS score. Opioid consumption was recorded. Primary outcome measures included immediate postoperative back pain VAS score, opioid consumption and infection rate. Patients were reviewed in clinic at 6 weeks, 6 months and 1 year postoperatively. Results None of the patients in Group A required further analgesia while 12 Group B patients required further treatment with tramadol (p = 0.01). At 3 h postoperatively the VAS score was significantly lower in Group A compared to Group B (p 
ISSN:0976-5662
2213-3445
DOI:10.1016/j.jcot.2019.03.005