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Influence of infiltration anaesthesia on perioperative outcomes following lumbar discectomy under surgical pleth index-guided general anaesthesia: A preliminary report from a randomised controlled prospective trial.
- Source :
-
Advances in medical sciences [Adv Med Sci] 2020 Mar; Vol. 65 (1), pp. 149-155. Date of Electronic Publication: 2020 Jan 13. - Publication Year :
- 2020
-
Abstract
- Purpose: Severe postoperative pain (SPP) may occur after lumbar discectomy. To prevent SPP and reduce rescue opioid consumption, infiltration anaesthesia (IA) has been combined with general anaesthesia (GA). This study verified how GA combined with IA facilitated intra- and postoperative demand for opioids and affected the incidence of SPP in patients subjected to open lumbar discectomy.<br />Materials/methods: Ninety-nine patients undergoing lumbar discectomy under GA with Surgical Pleth Index (SPI)-guided fentanyl (FNT) administration were randomly assigned to receive IA combined with either 0.2% bupivacaine (BPV) or 0.2% ropivacaine (RPV) with FNT 50 μg and compared with controls (BF, RF, and C groups, respectively).<br />Results: Ninety-four patients were included in the final analysis. Adjusted according to SPI, total intraoperative FNT dosages did not differ between the study groups (p = 0.23). The proportion of patients who reported SPP was the highest in group C (41.9%) than in the RF (12.9%) and BF groups (31.3%) (p < 0.05). Mild pain was experienced by 67.7%, 53.1% and 32.3% of patients from the RF, BF and C groups, respectively (p < 0.01). Morphine requirement was the highest in the control group (7.1 ± 5.9 mg), followed by the RF (2.7 ± 5.3 mg) and BF groups (4 ± 4.9 mg) (p < 0.05).<br />Conclusions: IA using RPV/FNT mixture significantly reduced SPP and postoperative demand for morphine in patients subjected to lumbar discectomy under GA.<br />Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest.<br /> (Copyright © 2019. Published by Elsevier B.V.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Lumbar Vertebrae pathology
Male
Middle Aged
Pain, Postoperative etiology
Prognosis
Prospective Studies
Young Adult
Analgesics, Opioid administration & dosage
Anesthesia, General methods
Anesthesia, Local methods
Bupivacaine administration & dosage
Diskectomy adverse effects
Lumbar Vertebrae surgery
Pain, Postoperative drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1898-4002
- Volume :
- 65
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Advances in medical sciences
- Publication Type :
- Academic Journal
- Accession number :
- 31945659
- Full Text :
- https://doi.org/10.1016/j.advms.2019.12.006