Efficacy of triamcinolone acetonide and bupivacaine for pain after lumbar discectomy.
The study is a prospective blinded randomised controlled trial to compare the efficacy of triamcinolone acetonide, bupivacaine or in combination in managing pain after lumbar discectomy. Patients undergoing primary single-level lumbar discectomy were randomised. Triamcinolone acetonide, bupivacaine or in combination was instilled at the nerve root as decompression. Preoperative, day 1 and 6 weeks pain score, 24-h postoperative opiate requirements and duration of inpatient stay were recorded. Data was analysed using Mann-Whitney test for statistical significance. 100 patients were recruited. A significant difference was noted in day one postoperative mean pain score, mean 24-h opiate requirement and mean inpatient stay in the triamcinolone acetonide and bupivacaine group. At 8 weeks postoperatively, no significant differences were seen in the pain score in all groups. Significant postoperative pain reduction and opiate requirements in the first 24 h, and significantly shortened duration of inpatient stay were achieved in the triamcinolone acetonide and bupivacaine group compared with other groups.
Department of Trauma and Reconstructive Surgery, Adelaide and Meath Hospital incorporating the National Children Hospital, Tallaght, Dublin 24, Republic of Ireland. syahbahari@gmail.com
Syah
S
Bahari
Mohamed
M
El-Dahab
May
M
Cleary
Joseph
J
Sparkes
D000698:Analgesia / Q000379:methods; D000779:Anesthetics, Local / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002045:Bupivacaine / Q000627:therapeutic use*; D017586:Diskectomy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D010147:Pain Measurement / Q000187:drug effects*; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*
D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide; D002045:Bupivacaine