Introduction: Achieving effective postoperative analgesia in postlaminectomy patients is a cumbersome task for the anesthesiologist. The need is to provide effective analgesia with minimal systemic side effects, cost-effectively, as laminectomy surgeries are associated with paramount postoperative pain. The purpose of this study was to compare the effectiveness of preemptive local infiltration of 0.5% levobupivacaine HCl vs 0.5% ropivacaine HCl for postoperative pain control in lumbar laminectomy patients.
Materials and methods: A total of 96 patients who were scheduled to undergo elective lumbar laminectomy were included in the study. Patients were randomly allocated to three groups. In groups I, II, and III, incisional site was infiltrated with 20 mL of 0.5% levobupivacaine HCl, 20 mL of 0.5% ropivacaine HCl, and 20 mL of 0.9% normal saline respectively. Demographic data, vital parameters, postoperative visual analog scale (VAS) scores, and total tramadol consumption were recorded.
Results: Time to first rescue analgesia was earliest in group III (8.72 ± 6.19 minutes), followed by group II (155 ± 39.53 minutes) and group I (208 ± 27.02 minutes) (p < 0.05). Group I has least total consumption of tramadol (253.1 ± 50.78 mg) at the end of 24 hours postoperatively when compared with group II (312.50 ± 33.60 mg) and group III (396.8 ± 40 mg) (p < 0.05). The overall VAS score in 24 hours was significantly lower in group I as compared with groups II and III. No significant adverse effects of local wound infiltration were observed.
Conclusion: This study suggests that preemptive infiltration of the incision site with levobupivacaine provides significantly better postoperative analgesia with minimal side effects.
Keywords: Central sensitization inhibition, Local infiltration, Lumbar laminectomy, Postoperative analgesia, Preemptive analgesia, Preincisional, Tramadol.
How to cite this article: Gupta S, Kashyap S, Bhadauria AS, Choudhary B. Preemptive Local Infiltration of 0.5% Levobupivacaine HCl vs 0.5% Ropivacaine HCl for Postoperative Pain Control in Lumbar Laminectomy Patients. J Recent Adv Pain 2017;3(1):30-35.
Source of support: Nil
Conflict of interest: None