Postoperative analgesic effect of bupivacaine infiltration following lumbar disc surgery

Year 2019, , 787 - 792, 04.09.2019

Tamer Tunçkale , Numan Karaarslan , Melek Tunçkale Tezcan Çalışkan

https://doi.org/10.18621/eurj.413635

Abstract

Objectives:
Effectiveness of 0.5% bupivacaine administered onto
dura, under lumbar superficial fascia and subcutaneous tissue on postoperative
pain control was analyzed in patients undergoing lumbar microdiscectomy.

Methods: Sixty
adult patients scheduled to undergo elective, single-level lumbar discectomy
were randomly divided into four groups: the control group (Control), the subcutaneous tissue group
(Group C), which received 20 ml of 0.5% bupivacaine in the subcutaenous tissue,
the superficial fascia group (Group F), which received 12 ml bupivacaine in the
subcutaneous tissue and 8 ml in the space below the lumbar superficial fascia,
and the dura group (Group D), which received a total of 20 ml (100 mg) of
bupivacaine, consisting of 10 ml in the subcutaneous tissue, 8 ml in the space below
the lumbar superficial fascia, and 2 ml on the dura. Visual
Analog Scale Values (VAS) on postoperative 0, 15, 30, 45 minutes, at 1, 2, 4, 6,
12 and 24^th hour and time of the first analgesic need were evaluated
for all patients and recorded.

Results: While
mean VAS value measured at min 0 (as soon as the patient awakened) was 2.3 ± 1.2
in Group D; it was 2.7 ± 0.9 in Group C; 2.7 ± 1.0 in Group F and 3.1 ± 0.6 in
control group (p = 0.232). At the
end of 1^th hour, mean VAS value was recorded as 2.8 ± 1.0 in Group D; 3.6 ± 1.5 in Group C; 3.6 ± 1.1 in Group F and 4.4 ± 1.1 in control group (p = 0.005). In Group D, 0.5% bupivacaine
administered as 2, 8, 10 ml onto dura, fascia and subcutaneously was detected
to provide significantly lower VAS values and significantly longer first
analgesic need time.

Conclusions: 0.5% bupivacaine administered onto
dura, under lumbar superficial fascia and in subcutaneous tissue was detected
to be a simple, effective and safe method in lumbar microdiscectomy operations. 

Keywords

lumbar microdisectomy, bupivacaine, pain, infiltration analgesia

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