title: Postoperative analgesic effects of wound infiltration with tramadol and levobupivacaine in lumbar disk surgeries.
abstract: BACKGROUND
  Wound infiltration with local anesthetics may improve postoperative analgesia. Tramadol has been shown to have effects similar to those of local anesthetics. The purpose of this study was to investigate the effects of wound infiltration with levobupivacaine and tramadol on postoperative analgesia for lumbar discectomies.
  
  
  METHODS
  Eighty adult patients who were scheduled to undergo elective lumbar discectomy operations were included in the study. Patients were randomly allocated to 4 groups: wound infiltration with 100 mg levobupivacaine (group L), 2 mg/kg tramadol (group T), 2 mg/kg tramadol plus 100 mg levobupivacaine (group LT), and saline (group C). Pain scores with the visual analog scale, patient-controlled analgesic consumption (pethidine), time to first analgesic treatment, and side effects were assessed during the postoperative period.
  
  
  RESULTS
  The time to first analgesia was earliest in group C (11.3±2.2 min), followed by group L (163.0±216.3 min) and group T (803.2±268.4 min) (P<0.001). None of the patients in group LT required postoperative analgesic supplementation, and the visual analog scale scores were <3 at all measurement times (P<0.05). Postoperative opioid consumption was 196.0±71.6 mg in group C, 129.0±78.3 mg in group L, and 37.0±35.4 mg in group T (P<0.001). The incidence of side effects was lower in group LT than in the other groups.
  
  
  CONCLUSIONS
  Wound infiltration with combined levobupivacaine and tramadol resulted in elimination of postoperative analgesic demand and reduction in the incidence of side effects. We conclude that infiltration of the wound site with combined levobupivacaine and tramadol provides significantly better analgesia compared with levobupivacaine or tramadol alone.
authors: Department of Anesthesiology and Reanimation, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey.
authors: Kadir
authors: K
authors: Ozyilmaz
authors: Hilal
authors: H
authors: Ayoglu
authors: Rahsan D
authors: RD
authors: Okyay
authors: Serhan
authors: S
authors: Yurtlu
authors: Bengu
authors: B
authors: Koksal
authors: Volkan
authors: V
authors: Hanci
authors: Gulay
authors: G
authors: Erdogan
authors: Isil O
authors: IO
authors: Turan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use*; D000758:Anesthesia; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000627:therapeutic use*; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000077554:Levobupivacaine; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008614:Meperidine / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011229:Preanesthetic Medication; D014147:Tramadol / Q000008:administration & dosage* / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D014147:Tramadol; D008614:Meperidine; D000077554:Levobupivacaine; D002045:Bupivacaine