title: WOUND INSTILLATION OF LOCAL ANESTHETIC BUPIVACAINE FOR POSTOPERATIVE ANALGESIA FOLLOWING LUMBAR LAMINECTOMY.
abstract: OBJECTIVE
  Lumbar laminectomy is a commonly performed procedure in neurosurgical and orthopedic practice. Postoperative pain reliefhelps in early mobilization, initiation of physiotherapy, provides satisfaction to the patients and plays an important role in reducing the morbidity and mortality. This prospective study investigated the simple technique of instillation of wound with bupivacaine and leaving a contact time of 60 seconds on postoperative pain following lumbar laminectomy.
  
  
  METHODS
  32 ASA I and II patients scheduled for laminectomy were randomly allocated to receive either 20 ml of normal saline (group I) or 0.25% of bupivacaine (group II) into the wound after securing hemostasis. After a dwell time of 60sec the wound was closed in layers without mopping or suctioning. After extubation, the pain scores were evaluated by visual analog scale at every 4 hrs. for 24hrs and also the time for first demand of analgesia, number of analgesic demands and the total amount of analgesia consumed were noted by an independent observer..
  
  
  RESULTS
  The median duration of analgesia in group I was 8.8 [5-11] and in group II 13 [8.5-16] hrs. with a p = 0.04. The number of demands and the amount of analgesia consumed was also statistically significant.
  
  
  CONCLUSIONS
  Wound instillation technique is simple, safe and effective in management of acute pain management after lumbar laminectomy and can be used as one among the multimodal armamentarium in pain management.
authors.forename: Nirmala
authors.initials: N
authors.lastname: Jonnavithula
authors.forename: Sandeep
authors.initials: S
authors.lastname: Garre
authors.forename: Sailakshman
authors.initials: S
authors.lastname: Pasupuleti
authors.forename: Padmaja
authors.initials: P
authors.lastname: Durga
authors.forename: Dilip Kumar
authors.initials: DK
authors.lastname: Kulkarni
authors.forename: Gopinath
authors.initials: G
authors.lastname: Ramachandran
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine