Intraoperative Perineural Infiltration of Lidocaine for Acute Postlaminectomy Pain

Torun, Fuat; Mordeniz, Cengiz; Baysal, Zeynep; Avcı, Emel; Togrul, Turhan; Karabağ, Hamza; Yıldız, İsmail

doi:10.1097/bsd.0b013e318198793c

Cited by 15 publications

(12 citation statements)

References 16 publications

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“…Torun et al evaluated the analgesic effects of a perineural infiltration with 0.5 ml of lidocaine 2% [40]. Patients in the control group did not receive any intervention.…”

Section: Locoregional Anaesthesiamentioning

confidence: 99%

Pain management after laminectomy: a systematic review and procedure-specific post-operative pain management (prospect) recommendations

et al. 2020

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Purpose With lumbar laminectomy increasingly being performed on an outpatient basis, optimal pain management is critical to avoid post-operative delay in discharge and readmission. The aim of this review was to evaluate the available literature and develop recommendations for optimal pain management after one- or two-level lumbar laminectomy. Methods A systematic review utilizing the PROcedure-SPECific Post-operative Pain ManagemenT (PROSPECT) methodology was undertaken. Randomised controlled trials (RCTs) published in the English language from 1 January 2008 until 31 March 2020—assessing post-operative pain using analgesic, anaesthetic and surgical interventions—were identified from MEDLINE, EMBASE and Cochrane Databases. Results Out of 65 eligible studies identified, 39 RCTs met the inclusion criteria. The analgesic regimen for lumbar laminectomy should include paracetamol and a non-steroidal anti-inflammatory drug (NSAID) or cyclooxygenase (COX)—2 selective inhibitor administered preoperatively or intraoperatively and continued post-operatively, with post-operative opioids for rescue analgesia. In addition, surgical wound instillation or infiltration with local anaesthetics prior to wound closure is recommended. Some interventions—gabapentinoids and intrathecal opioid administration—although effective, carry significant risks and consequently were omitted from the recommendations. Other interventions were also not recommended because there was insufficient, inconsistent or lack of evidence. Conclusion Perioperative pain management for lumbar laminectomy should include paracetamol and NSAID- or COX-2-specific inhibitor, continued into the post-operative period, as well as intraoperative surgical wound instillation or infiltration. Opioids should be used as rescue medication post-operatively. Future studies are necessary to evaluate the efficacy of our recommendations.

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“…Torun et al evaluated the analgesic effects of a perineural infiltration with 0.5 ml of lidocaine 2% [40]. Patients in the control group did not receive any intervention.…”

Section: Locoregional Anaesthesiamentioning

confidence: 99%

Pain management after laminectomy: a systematic review and procedure-specific post-operative pain management (prospect) recommendations

et al. 2020

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“…[8,10] There are very few recent studies reporting the usage of infiltration anaesthesia with local anaesthetics for relief of postoperative pain following lumbar laminectomy procedures. [11][12][13] Magnesium is widely used in perioperative settings and has shown to decrease the anaesthesia and analgesia requirements effectively. [9,14,15] And there are no studies revealing the use of magnesium as an adjuvant to infiltration anaesthesia following lumbar laminectomy.…”

Section: Introductionmentioning

confidence: 99%

Comparison of bupivacaine and bupivacaine plus magnesium sulphate infiltration for postoperative analgesia in patients undergoing lumbar laminectomy: A prospective randomised double-blinded controlled study

Donadi

Moningi

Ramachandran

2014

Journal of Neuroanaesthesiology and Critical Care

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Background: Laminectomy is associated with considerable postoperative pain. Providing analgesia locally in the area of surgical trauma, with minimal systemic side effects, is an attractive option and has become an integral part of multimodal analgesia. The objective of this study was to assess and compare the effectiveness and safety of local infiltration of bupivacaine and bupivacaine plus magnesium sulphate for postoperative analgesia in patients undergoing lumbar laminectomy. Materials and Methods: Sixty adult patients of the American Society of Anaesthesiologists (ASA) class 1 and 2 were randomly allocated into two groups, comprising 30 patients in each group. After the completion of lumbar laminectomy, the study drug was locally infiltrated into the paravertebral muscles on either side. Group bupivacaine with magnesium (BM) was given 20 ml of 0.25% bupivacaine with 500 mg of magnesium sulphate (constituted with normal saline); and Group bupivacaine (B) was given 20 ml of 0.25% bupivacaine constituted with normal saline. Postoperative visual analogue scale (VAS) pain scores at 1, 2, 4, 6, 8, 12 and 24 hours; rescue analgesia, the time to first analgesic consumption, degree of overall patient satisfaction and side effects were recorded. Comparison of continuous data between groups was done using independent T-test. Comparison of nominal data was done using Chi-square analysis and ordinal data using Mann-Whitney test. A P value less than 0.05 was considered significant. Results: Time to first analgesic consumption was significantly longer in BM group (7.78 ± 1.350 hours) compared to B group (4.62 ± 0.997 hours) (P < 0.0001). The consumption of Tramadol was significantly higher in B group (202.5 ± 76.9 mg) compared to BM (117.5 ± 63.4 mg) (P < 0.0001). The degree of overall satisfaction with postoperative pain management on a 4-point satisfaction scale was better in BM group (2.77 ± 0.626) compared to B group (2.0 ± 0.587) (P < 0.001). Conclusion: Wound infiltration with bupivacaine and magnesium sulphate provided better pain control and analgesic effect was more significant, providing effective and safe postoperative analgesia in patients undergoing laminectomy surgeries.

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“…We chose regional anesthesia and local infiltration in this case [17,18]. Though it is not free of nausea [5], regional anesthesia can eliminate multiple emetogenic triggers such as inhaled agents and opioids [13,14].…”

Section: Discussionmentioning

confidence: 99%

CASE REPORT - -Combined General and Spinal Anesthesia for Lumbar decompression in an Opioid-intolerant Patient: Intra-operative Administration of Intrathecal Bupivacaine via the Surgical Incision

Wilkins¹,

Alston²,

Wang

2012

TOATJ

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Abstract:We illustrate repeat dosing of spinal anesthesia as a means to avoid opioids during lumbar surgery for a patient intolerant of opioids.A patient required redo lumbar surgery but had a marked history of nausea, vomiting and retching in response to opioids. A propofol-based anesthetic was supplemented with intravenous ketamine and intrathecal bupivacaine. The first dose of bupivacaine receded during the lengthy surgical procedure but was supplemented by means of a 25-gauge pencil-point needle passed through the exposed dura. Postoperatively, there was no spinal fluid leak, no headache, and no nausea.Supplementation of intrathecal anesthesia under direct dural vision during lengthy lumbar surgery is facile, can help to obviate a need for opioids, and can aid in avoidance of postoperative nausea and vomiting.

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Intraoperative Perineural Infiltration of Lidocaine for Acute Postlaminectomy Pain

Cited by 15 publications

References 16 publications

Pain management after laminectomy: a systematic review and procedure-specific post-operative pain management (prospect) recommendations

Pain management after laminectomy: a systematic review and procedure-specific post-operative pain management (prospect) recommendations

Comparison of bupivacaine and bupivacaine plus magnesium sulphate infiltration for postoperative analgesia in patients undergoing lumbar laminectomy: A prospective randomised double-blinded controlled study

CASE REPORT - -Combined General and Spinal Anesthesia for Lumbar decompression in an Opioid-intolerant Patient: Intra-operative Administration of Intrathecal Bupivacaine via the Surgical Incision

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