Preemptive wound infiltration in lumbar laminectomy for postoperative pain: comparison of bupivacaine and levobupivacaine

Turk Neurosurg. 2014;24(1):48-53. doi: 10.5137/1019-5149.JTN.8431-13.0.

Abstract

Aim: Patients usually suffer significant pain after lumbar laminectomy. Wound infiltration with local anesthetics is a useful method for postoperative pain control. Our aim was to compare the efficacies of preemptive wound infiltration with bupivacaine and levobupivacaine.

Material and methods: 60 patients were randomized three groups as follows: Group L wound infiltration with 20 mL 0.25% levobupivacaine and 40 mg methylprednisolone just before wound closure; Group B wound infiltration with 20 mL 0.25% bupivacaine and 40 mg methylprednisolone before closure; Group C had this region infiltrated with 20 ml physiological saline. Demographic data, vital signs, postoperative pain scores and morphine usage were recorded.

Results: First analgesic requirement time was significantly shorter in the control group compared to other two groups (p < 0.001). Group B had the lowest cumulative morphine consumption at the end of 24 hours within 0-4, 4-12 and 12-24 hours time intervals and the values were not significant when compared with Group L, however the consumption of both groups was significantly lower compared to the control group (p < 0.001).

Conclusion: Our data suggest that preoperative infiltration of the wound site with bupivacaine or levobupivacaine provides similarly effective pain control with reduced opiate dose after unilateral lumbar laminectomy.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / therapeutic use
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / adverse effects
  • Anesthetics, Local / therapeutic use*
  • Blood Pressure / drug effects
  • Bupivacaine / administration & dosage
  • Bupivacaine / adverse effects
  • Bupivacaine / analogs & derivatives*
  • Bupivacaine / therapeutic use
  • Double-Blind Method
  • Female
  • Heart Rate / drug effects
  • Humans
  • Intervertebral Disc / surgery
  • Laminectomy / methods*
  • Levobupivacaine
  • Lumbar Vertebrae / surgery
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Morphine / administration & dosage
  • Morphine / therapeutic use
  • Pain Measurement
  • Pain, Postoperative / prevention & control*
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Analgesics, Opioid
  • Anesthetics, Local
  • Morphine
  • Levobupivacaine
  • Methylprednisolone
  • Bupivacaine