The effects of pre-emptive analgesia with bupivacaine on acute post-laminectomy pain.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
Our data suggests that pre-emptive analgesia via perineural infiltration of bupivacaine is a simple, and effective method for post-operative acute pain relief.
Mordeniz
Cengiz
C
Department of Anesthesiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey. cengizmorster@gmail.com
Torun
Fuat
F
Soran
Ahmet Faruk
AF
Beyazoglu
Orhan
O
Karabag
Hamza
H
Cakir
Ahmet
A
Yucetas
Seyho Cem
SC
D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001416:Back Pain / Q000601:surgery*; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D007796:Laminectomy; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D000779:Anesthetics, Local; D002045:Bupivacaine