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Year 2019, Volume: 5 Issue: 5, 787 - 792, 04.09.2019

Tamer Tunçkale Numan Karaarslan Melek Tunçkale Tezcan Çalışkan

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

Abstract

References

  • [1] Apostolides PJ, Jocobowitz R, Sonntag VKH. Lumbar discectomy microdiscectomy: “the gold standard”. Clin Neurosurg 1995;43:228-38.
  • [2] Erdine S. Postoperatif analjezi. In: Erdine S, ed. Ağrı sendromları ve tedavisi. 2nd ed., İstanbul: Gizben Maatbacılık, 2003;33-3.
  • [3] Nagy I, Rice ASC. Applied physiogy of inflammatory pain. In: Rowbotham DJ, Macinteyre PE, eds. Clinical Pain Management: Acute Pain. London: Arnold Publishers, 2003:17-47.
  • [4] Kantor TG. Physiology and treatment of pain and inflammation: analgesic effects of flurbiprofen. Am J Med 1986;80(Suppl 1);3-9.
  • [5] Avtan L, Berber E, Avcı C. Laparoskopik cerrahide postoperatif analjezi. Ağrı Dergisi 1996;8:22-5.
  • [6] Benumof JL. Management of postoperative pain. In: Benumof JL, ed. Anesthesia for Thoracic Surgery. 2nd ed.. Philedelphia, W.B: Sounders Company, 1995:756-74.
  • [7] Mitchell RW, Smith G. The control of acute postoperative pain. Br J Anaesth 1989;63:147-58.
  • [8] Schenk MR, Putzier M, Kügler B, Tohtz S, Voigt K, Schink T, et al. Postoperative analgesia after major spine surgery: patient-controlled epidural analgesia versus patient-controlled intravenous analgesia. Anesth Analg 2006;103:1311-7.
  • [9] Ersayli DT, Gurbet A, Bekar A, Uckunkaya N, Bilgin H. Effects of perioperatively administered bupivacaine and bupivacaine-methylprednisolone on pain after lumbar discectomy. Spine 2006;31:2221-6.
  • [10] Wright JE. Controlled trial of wound infiltration with bupivacaine for postoperative pain relief after apendicectomy in children. Br J Surg 1993;80:110-1.
  • [11] Yaşar MA, Erdoğan M, Özmiş M, Akkuş MA, Erhan ÖL. Tiroid cerrahisinde uygulanan bupivakain infiltrasyonunun postoperatif analjezik etkinliği. Ağrı Dergisi 1994;9:35-37.
  • [12] Leung CC, Chan YM, Ngai SW, Ng KF, Tsui SL. Effect of pre-incision skin infiltration on post-hysterectomy pain--a double-blind randomized controlled trial. Anaesth Intensive Care 2000;28:510-6.
  • [13] Fozzard HA, Lee PJ, Lipkind GM. Mechanism of local anesthetic drug action on voltage-gated sodium channels. Curr Pharm Des 2005;11:2671-86.
  • [14] Mirzai H, Tekin I, Alincak H. Perioperative use of corticosteroid and bupivacaine combination in lumbar disc surgery: a randomized controlled study. Spine 2002;27:343-6.
  • [15] Kotil K, Tunckale T, Tatar Z, Koldas M, Kural A, Bilge T. Serum creatine phosphokinase activity and histological changes in the multifidus muscle: a prospective randomized controlled comparative study of discectomy with or without retraction. J Neurosurg Spine 2007;6:121-5.
  • [16] Shin DA, Kim KN, Shin HC, Yoon DH. The efficacy of microendoscopic discectomy in reducing iatrogenic muscle injury. J Neurosurg Spine 2008;8:39-43.
  • [17] Jitpakdee T, Mandee S. Strategies for preventing side effects of systemic opioid in postoperative pediatric patients. Pediatr Anesth 2014;24:561-8.
  • [18] Cherian MN, Mathews MP, Chandy MJ. Local wound infiltration with bupivacaine in lumbar laminectomy. Surg Neurol 1997;47:120-2; discussion 122-3.
  • [19] Hernandez-Palazon J, Tortosa Serrano JA, Burguillos Lopez S, Molero Molero E. [Infiltration of the surgical wound with local anesthetic for postoperative analgesia in patients operated on for lumbar disc herniation. Comparative study of ropivacaine and bupivacaine]. Rev Esp Anestesiol Reanim 2001;48:17-20. [Article in Spanish]
  • [20] Puffer RC, Tou K, Winkel RE, Bydon M, Currier B, Freedman BA. Liposomal bupivacain incisional injection in single-level lumbar spine surgery. Spine J 2016;16:1305-8.
  • [21] Kim J, Burke SM, Kryzanski JT, Roberts RJ, Roguski M, Qu E, et al. The role of liposomal bupivacaine in reduction of postoperative pain after transforaminal lumbar interbody fusion: a clinical study. World Neurosurg 2016;91:460-7.

Postoperative analgesic effect of bupivacaine infiltration following lumbar disc surgery

Year 2019, Volume: 5 Issue: 5, 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 24th 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 1th 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

References

  • [1] Apostolides PJ, Jocobowitz R, Sonntag VKH. Lumbar discectomy microdiscectomy: “the gold standard”. Clin Neurosurg 1995;43:228-38.
  • [2] Erdine S. Postoperatif analjezi. In: Erdine S, ed. Ağrı sendromları ve tedavisi. 2nd ed., İstanbul: Gizben Maatbacılık, 2003;33-3.
  • [3] Nagy I, Rice ASC. Applied physiogy of inflammatory pain. In: Rowbotham DJ, Macinteyre PE, eds. Clinical Pain Management: Acute Pain. London: Arnold Publishers, 2003:17-47.
  • [4] Kantor TG. Physiology and treatment of pain and inflammation: analgesic effects of flurbiprofen. Am J Med 1986;80(Suppl 1);3-9.
  • [5] Avtan L, Berber E, Avcı C. Laparoskopik cerrahide postoperatif analjezi. Ağrı Dergisi 1996;8:22-5.
  • [6] Benumof JL. Management of postoperative pain. In: Benumof JL, ed. Anesthesia for Thoracic Surgery. 2nd ed.. Philedelphia, W.B: Sounders Company, 1995:756-74.
  • [7] Mitchell RW, Smith G. The control of acute postoperative pain. Br J Anaesth 1989;63:147-58.
  • [8] Schenk MR, Putzier M, Kügler B, Tohtz S, Voigt K, Schink T, et al. Postoperative analgesia after major spine surgery: patient-controlled epidural analgesia versus patient-controlled intravenous analgesia. Anesth Analg 2006;103:1311-7.
  • [9] Ersayli DT, Gurbet A, Bekar A, Uckunkaya N, Bilgin H. Effects of perioperatively administered bupivacaine and bupivacaine-methylprednisolone on pain after lumbar discectomy. Spine 2006;31:2221-6.
  • [10] Wright JE. Controlled trial of wound infiltration with bupivacaine for postoperative pain relief after apendicectomy in children. Br J Surg 1993;80:110-1.
  • [11] Yaşar MA, Erdoğan M, Özmiş M, Akkuş MA, Erhan ÖL. Tiroid cerrahisinde uygulanan bupivakain infiltrasyonunun postoperatif analjezik etkinliği. Ağrı Dergisi 1994;9:35-37.
  • [12] Leung CC, Chan YM, Ngai SW, Ng KF, Tsui SL. Effect of pre-incision skin infiltration on post-hysterectomy pain--a double-blind randomized controlled trial. Anaesth Intensive Care 2000;28:510-6.
  • [13] Fozzard HA, Lee PJ, Lipkind GM. Mechanism of local anesthetic drug action on voltage-gated sodium channels. Curr Pharm Des 2005;11:2671-86.
  • [14] Mirzai H, Tekin I, Alincak H. Perioperative use of corticosteroid and bupivacaine combination in lumbar disc surgery: a randomized controlled study. Spine 2002;27:343-6.
  • [15] Kotil K, Tunckale T, Tatar Z, Koldas M, Kural A, Bilge T. Serum creatine phosphokinase activity and histological changes in the multifidus muscle: a prospective randomized controlled comparative study of discectomy with or without retraction. J Neurosurg Spine 2007;6:121-5.
  • [16] Shin DA, Kim KN, Shin HC, Yoon DH. The efficacy of microendoscopic discectomy in reducing iatrogenic muscle injury. J Neurosurg Spine 2008;8:39-43.
  • [17] Jitpakdee T, Mandee S. Strategies for preventing side effects of systemic opioid in postoperative pediatric patients. Pediatr Anesth 2014;24:561-8.
  • [18] Cherian MN, Mathews MP, Chandy MJ. Local wound infiltration with bupivacaine in lumbar laminectomy. Surg Neurol 1997;47:120-2; discussion 122-3.
  • [19] Hernandez-Palazon J, Tortosa Serrano JA, Burguillos Lopez S, Molero Molero E. [Infiltration of the surgical wound with local anesthetic for postoperative analgesia in patients operated on for lumbar disc herniation. Comparative study of ropivacaine and bupivacaine]. Rev Esp Anestesiol Reanim 2001;48:17-20. [Article in Spanish]
  • [20] Puffer RC, Tou K, Winkel RE, Bydon M, Currier B, Freedman BA. Liposomal bupivacain incisional injection in single-level lumbar spine surgery. Spine J 2016;16:1305-8.
  • [21] Kim J, Burke SM, Kryzanski JT, Roberts RJ, Roguski M, Qu E, et al. The role of liposomal bupivacaine in reduction of postoperative pain after transforaminal lumbar interbody fusion: a clinical study. World Neurosurg 2016;91:460-7.
There are 21 citations in total.

Details

Primary Language English
Subjects Surgery, Anaesthesiology, Neurosciences
Journal Section Original Articles
Authors

Tamer Tunçkale 0000-0002-4534-0864

Numan Karaarslan 0000-0001-5590-0637

Melek Tunçkale This is me 0000-0002-7777-5993

Tezcan Çalışkan 0000-0001-7735-0584

Publication Date September 4, 2019
Submission Date April 9, 2018
Acceptance Date December 14, 2018
Published in Issue Year 2019 Volume: 5 Issue: 5

Cite

AMA Tunçkale T, Karaarslan N, Tunçkale M, Çalışkan T. Postoperative analgesic effect of bupivacaine infiltration following lumbar disc surgery. Eur Res J. September 2019;5(5):787-792. doi:10.18621/eurj.413635
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