Abstract
PurposeA prospective randomized clinical trial was carried out to observe the analgesic efficacy of ropivacaine for postoperative pain following thoracolumbar spinal surgery.MethodsSeventy-one patients with elective posterior thoracolumbar spinal surgery were randomly divided into two groups. Local group received 0.33 % ropivacaine by pump through the wound, and intravenous group received flurbiprofen axetil, pentazocine and palonosetron via intravenous pump. We evaluated the level of pain, the incidence of adverse reactions at 2, 4, 6, 12, 24, 36 and 48 h after operation, and the occurrence of chronic pain 3 months later.ResultsThere were no significant differences in the pain level between the two groups. However, the incidence of nausea, vomiting and chronic pain was significantly lower in the local group.ConclusionsOur results showed that local infusion of ropivacaine achieved similar analgesic effects to intravenous delivery of analgesic drugs, but significantly reduced incidence of nausea, vomiting and chronic pain.
Highlights
Pain is the most commonly reported symptom in primary care after spinal surgery, while musculoskeletal pain accounts for half of all reported pain complaints [1]
Purpose A prospective randomized clinical trial was carried out to observe the analgesic efficacy of ropivacaine for postoperative pain following thoracolumbar spinal surgery
The incidence of nausea, vomiting and chronic pain was significantly lower in the local group
Summary
Pain is the most commonly reported symptom in primary care after spinal surgery, while musculoskeletal pain accounts for half of all reported pain complaints [1]. Wound infusion with local anesthetics can continuously infiltrate the peripheral nerve endings, and attenuates pain by directly blocking the neuronal membrane sodium channels. The time-limited effect of single bolus administration can be further improved through continuous surgical wound infusion techniques using multi-orificetype catheters, positioned by the surgeon at the end of the procedure. A systematic review [4] of randomized controlled trials confirmed the benefits and safety of this technique when applied following several severely painful procedures, such as cardiac, thoracic and major gynecologic surgery. This technique remains effective in spinal surgery. We evaluated and recorded the long-term effects of incisional local anesthesia on incidence of postoperative chronic pain and infection, compared with postoperative intravenous continuous constantdose analgesia (ICCA)
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