Abstract
BackgroundSurgical procedure usually causes serious postoperative pain and poor postoperative pain management negatively affects quality of life, function and recovery time. We aimed to investigate the role of wound infiltration with ropivacaine as an adjuvant to patient controlled analgesia (PCA) in postoperative pain control for patients undergoing transforaminal lumbar interbody fusion.MethodsOne hundred twelve patients undergoing lumbar fusion were retrospectively reviewed and divided into two groups (ropivacaine and control groups) according to whether received wound infiltration with ropivacaine or not. Visual Analogue Scale (VAS) score, analgesics consumption, number of patients requiring rescue analgesic, hospital duration and incidence of complications were recorded. Surgical trauma was assessed using operation time, intraoperative blood loss and incision length.ResultsThe amount of sufentanil consumption in ropivacaine group at 4 h postoperatively was lower than that of control group (24.5 ± 6.0 μg vs 32.1 ± 7.0 μg, P < 0.001) and similar results were observed at 8, 12, 24, 48 and 72 h postoperatively(P < 0.001). Fewer patients required rescue analgesia within 4 to 8 h postoperatively in ropivacaine group (10/60 vs 19/52, P = 0.017). Length of postoperative hospital durations were shorter in patients receiving ropivacaine infiltration compared to control cohorts (6.9 ± 0.9 days vs 7.4 ± 0.9 days, P = 0.015). The incidence of PONV in ropivacaine group was lower than that in control group (40.4% vs 18.3%, P = 0.01). However, VAS scores were similar in two groups at each follow-up points postoperatively, and no difference was observed(P > 0.05).ConclusionWound infiltration with ropivacaine effectively reduces postoperative opioid consumption and PONV and may be a useful adjuvant to PCA to improve recovery for patients undergoing lumbar spine surgery.
Highlights
Surgical procedure usually causes serious postoperative pain and poor postoperative pain management negatively affects quality of life, function and recovery time
In this study, we adopted wound infiltration with ropivacaine as an adjuvant to patient controlled analgesia (PCA) in Transforaminal lumbar interbody fusion (TLIF) procedure to assess its efficacy in postoperative pain management
Since Mullen and Cook first demonstrated the use of wound infiltration with local anesthetics in spine surgery in 1979 [16], a few literatures reported the application of wound infiltration with local anesthetics in several surgical procedures
Summary
Surgical procedure usually causes serious postoperative pain and poor postoperative pain management negatively affects quality of life, function and recovery time. Transforaminal lumbar interbody fusion (TLIF) has been widely used in treatment of lumbar degenerative spine disorders, and achieved good clinical results and high patient satisfaction [1, 2]. It can decompress the nerve roots, immobilize the instrumented segments and provide stability of spine. Surgical procedure usually causes serious postoperative pain and poor pain management negatively affects quality of life, function, and recovery [3]. Finding other analgesic strategies with fewer potentially adverse effects will be beneficial for patients suffering from postoperative pain
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