title: Does wound irrigation with triamcinolone reduce pain after surgery to the lumbar spine?
abstract: This prospective, randomized study compared postoperative pain scores, morphine consumption and length of stay in 95 adults who underwent elective lumbar spine surgery via a posterior incision. Immediately prior to closure the wound was irrigated with triamcinolone 40, 20 or 0 mg. Visual analogue scale pain scores at 24 h after surgery were median 12 (interquartile range 3-24), 15 (6-34) and 33 (20-59) mm for patients receiving triamcinolone 40, 20 mg or no steroid, respectively (P < 0.0005, Kruskal-Wallis test). Total morphine usage after 24 h was 26 (21-39), 27 (17-43) and 43 (27-73) mg for the same groups (P < 0.001, Kruskal-Wallis test). The proportion of patients discharged from hospital on the first day after surgery was 83.9, 77.4 and 54.8% for patients receiving triamcinolone 40, 20 mg and no steroid, respectively (P < 0.028, chi-squared test). Extra-dural triamcinolone reduces pain after lumbar spine surgery and reduces time to discharge from hospital.
authors.affiliation: Department of Neurosurgery, Derriford Hospital, Plymouth, UK.
authors.forename: L H
authors.initials: LH
authors.lastname: Pobereskin
authors.forename: J R
authors.initials: JR
authors.lastname: Sneyd
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D013122:Spinal Diseases / Q000601:surgery*; D007507:Therapeutic Irrigation; D014221:Triamcinolone / Q000627:therapeutic use*
chemical_list: D000701:Analgesics, Opioid; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D014221:Triamcinolone; D009020:Morphine