The effect of intraoperative epidural levobupivacaine administration in lumbar disc surgery for postoperative pain

Abstract

Aim: Postoperative pain is an essential problem that affects morbidity in surgical cases. We aimed to provide maximal benefits with minimal side effects, facilitate the recovery period, accelerate mobilization, and provide patient safety and comfort through the usage of the drug and method of our choice to provide postoperative analgesia.Material and Method: Our study included 60 elective or urgent lumbar disc surgery cases. The patients were randomly divided into two groups; (a) The Group S; patients receiving general anesthesia and intraoperative epidural saline injection, and (b) The Group L; patients receiving general anesthesia and intraoperative epidural 2.5 mg/mL levobupivacaine 10 mL injection. The patient’s hemodynamic parameters were monitored perioperatively. To all patients, in case of necessity, patient-controlled analgesia with IV morphine was administered. The pain assessment was done using a numeric pain rating scale and visual analog scale. In addition, morphine usage during the 24 hours, pain scores, mobilization time, patient satisfaction, and side effects were evaluated.Results: In the levobupivacaine group, the pain scores were lower during the whole trial, the morphine consumption in the 24 hour period was lower, the first time of mobilization was shorter, the patient satisfaction was more remarkable, and this group was more clinically significant considering side effects.Conclusion: The usage of epidural bupivacaine combined with IV morphine instead of IV morphine alone for postoperative analgesia is more beneficial for early mobilization, reducing complications, and better patient satisfaction