EFFECT OF PEROPERATIVE LOCAL LEVOBUPIVACAINE INFILTRATION TO PREVENT POSTOPERATIVE PAIN IN LUMBAR DISC HERNIECTOMY
Main Article Content
Abstract
- 1. ABSTRACT
1.1. Background: It is aimed to search if peroperative levobupivacaine infiltration over the dorsal root can prevent postoperative pain.
1.2. Materials and Methods: This study was performed between the dates February 2010-May 2012 in the Neurosurgical Department of Adıyaman Research and Application Hospital, in Turkey, among 120 patients who were operated for lumbar disc herniectomy. Half of them were given peroperative levobupivacaine (2 cc) on the related dorsal root, and the other half received serum physiologic (2 cc). After ten minutes, the operation continued. Postoperatively, the analgesic requirement, of the patients were followed for 72 hours. The data is analyzed with Kolmogorov Smirnov analysis to check normal distribution. The data was convenient (p>0.05). Measurable data was analyzed with student t test and the comparison was made with chi-square (c2). The data was evaluated in the confidence interval of 95% for both directions.
1.3. Results: The patients in the control group required analgesia immediately after the operation but in the levobupivacaine group the earliest analgesic requirement was after 4 hours, but some of the patients did not need any analgesic even up to 50 hours.
1.4. Conclusion: We propose that peroperative local anesthetic infiltration reduced significantly postoperative analgesic requirement.
1.5. Key words: lumbar disc herniectomy, levobupivacaine, postoperative analgesia, preemptive analgesia
Article Details
How to Cite
CEM YÜCETAŞ, Şeyho; MORDENIZ, Cengiz; UCLER, Necati.
EFFECT OF PEROPERATIVE LOCAL LEVOBUPIVACAINE INFILTRATION TO PREVENT POSTOPERATIVE PAIN IN LUMBAR DISC HERNIECTOMY.
Medical Research Archives, [S.l.], v. 4, n. 5, sep. 2016.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/571>. Date accessed: 26 dec. 2024.
Keywords
lumbar disc herniectomy, levobupivacaine, postoperative analgesia, preemptive analgesia
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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13. Dionne R. Preemptive vs preventive analgesia: which approach improves clinical outcomes? Compendium of continuing education in dentistry. 2000;21(1):48, 51-4, 6. PubMed PMID: 11199689.
14. Kamaz A SO, Oksuz H,. Comparison of wound infiltration with bupivacaine and levobupivacaine for postoperative analgesia in patients operated for lumbar disc herniation. Anatol J Clin Investing. 2008;2(4):141-5.
15. Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science. 2000;288(5472):1765-9. PubMed PMID: 10846153.
16. Kehlet H, Dahl JB. The value of "multimodal" or "balanced analgesia" in postoperative pain treatment. Anesth Analg. 1993;77(5):1048-56. PubMed PMID: 8105724.
17. Ioannidis O, Anastasilakis CD, Varnalidis I, Paraskevas G, Malakozis SG, Gatzos S, et al. Intraperitoneal administration of local anesthetics in laparoscopic surgery: pharmacological, anatomical, physiological and pathophysiological considerations. Minerva chirurgica. 2013;68(6):599-612. PubMed PMID: 24193292.
18. Paul A, Mishra A, Bandyopadhyay K, Afzal M, Mookerjee S. Pre-emptive analgesia: Recent trends and evidences2013 September 1, 2013. 114-20 p.
19. McQuay HJ, Carroll D, Moore RA. Postoperative orthopaedic pain--the effect of opiate premedication and local anaesthetic blocks. Pain. 1988;33(3):291-5. PubMed PMID: 3419836.
20. Dagher C NN, Narchi P, Hage P, Antakly MC,. Regional anesthesia for lumbar microdiscectomy. J Med Liban. 2002 Sep-Dec;50(5-6):206-10.
21. Ejlersen E, Andersen HB, Eliasen K, Mogensen T. A comparison between preincisional and postincisional lidocaine infiltration and postoperative pain. Anesthesia and analgesia. 1992;74(4):495-8. PubMed PMID: 1482431.
22. Bashandy GM, Elkholy AH. Reducing postoperative opioid consumption by adding an ultrasound-guided rectus sheath block to multimodal analgesia for abdominal cancer surgery with midline incision. Anesthesiology and pain medicine. 2014;4(3):e18263. doi: 10.5812/aapm.18263. PubMed PMID: 25289373; PubMed Central PMCID: PMC4183078.
23. Mirza F, Carvalho B. Transversus abdominis plane blocks for rescue analgesia following Cesarean delivery: a case series. Canadian journal of anaesthesia = Journal canadien d'anesthesie. 2013;60(3):299-303. doi: 10.1007/s12630-012-9866-6. PubMed PMID: 23263981.
24. Kim HS, Lee HK, Jeong HS, Shin HW. Decreased postoperative pain after reduction of fractured nasal bones using a nerve block of the anterior ethmoidal nerve. International journal of oral and maxillofacial surgery. 2013;42(6):727-31. doi: 10.1016/j.ijom.2013.01.017. PubMed PMID: 23528745.
25. Burlacu CL, Buggy DJ. Update on local anesthetics: focus on levobupivacaine. Ther Clin Risk Manag. 2008;4(2):381-92. PubMed PMID: 18728849; PubMed Central PMCID: PMCPMC2504073.
26. Vadivelu N, Mitra S, Schermer E, Kodumudi V, Kaye AD, Urman RD. Preventive analgesia for postoperative pain control: a broader concept. Local Reg Anesth. 2014;7:17-22. doi: 10.2147/LRA.S62160. PubMed PMID: 24872720; PubMed Central PMCID: PMCPMC4012350.
27. Gurbet A, Bekar A, Bilgin H, Korfali G, Yilmazlar S, Tercan M. Pre-emptive infiltration of levobupivacaine is superior to at-closure administration in lumbar laminectomy patients. Eur Spine J. 2008;17(9):1237-41. doi: 10.1007/s00586-008-0676-z. PubMed PMID: 18425538; PubMed Central PMCID: PMC2527409.
28. Simon E, Bank J, Gal J, Siro P, Novak L, Fulesdi B, et al. Administration of preemptive analgesia by diclofenac to prevent acute postcraniotomy headache. Ideggyogyaszati szemle. 2012;65(9-10):302-6. PubMed PMID: 23126214.
29. Chan ZH, Balakrishnan V, McDonald A. Short versus long-acting local anaesthetic in open carpal tunnel release: which provides better preemptive analgesia in the first 24 hours? Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand. 2013;18(1):45-7. doi: 10.1142/S0218810413500081. PubMed PMID: 23413849.
30. Kim TH, Kang H, Choi YS, Park JM, Chi KC, Shin HY, et al. Pre- and intraoperative lidocaine injection for preemptive analgesics in laparoscopic gastrectomy: a prospective, randomized, double-blind, placebo-controlled study. Journal of laparoendoscopic & advanced surgical techniques Part A. 2013;23(8):663-8. doi: 10.1089/lap.2012.0542. PubMed PMID: 23614819.
31. Torun F, Mordeniz C, Baysal Z, Avci E, Togrul T, Karabag H, et al. Intraoperative perineural infiltration of lidocaine for acute postlaminectomy pain: preemptive analgesia in spinal surgery. Journal of spinal disorders & techniques. 2010;23(1):43-6. doi: 10.1097/BSD.0b013e318198793c. PubMed PMID: 20065867.
32. Mordeniz C, Torun F, Soran AF, Beyazoglu O, Karabag H, Cakir A, et al. The effects of pre-emptive analgesia with bupivacaine on acute post-laminectomy pain. Archives of orthopaedic and trauma surgery. 2010;130(2):205-8. doi: 10.1007/s00402-009-0961-2. PubMed PMID: 19727781.
33. Younessi OJ, Punnia-Moorthy A. Cardiovascular effects of bupivacaine and the role of this agent in preemptive dental analgesia. Anesthesia progress. 1999;46(2):56-62. PubMed PMID: 10853566; PubMed Central PMCID: PMC2148896.
34. Nesioonpour S, Akhondzadeh R, Pipelzadeh MR, Rezaee S, Nazaree E, Soleymani M. The effect of preemptive analgesia with bupivacaine on postoperative pain of inguinal hernia repair under spinal anesthesia: a randomized clinical trial. Hernia : the journal of hernias and abdominal wall surgery. 2013;17(4):465-70. doi: 10.1007/s10029-012-1007-1. PubMed PMID: 23104320.
35. Valente DS. Preemptive analgesia with bupivacaine in reduction mammaplasty: a prospective, randomized, double-blind, placebo-controlled trial. Plastic and reconstructive surgery. 2014;134(4):581-6. doi: 10.1097/PRS.0000000000000522. PubMed PMID: 24945948.
36. Goyal N, McKenzie J, Sharkey PF, Parvizi J, Hozack WJ, Austin MS. The 2012 Chitranjan Ranawat award: intraarticular analgesia after TKA reduces pain: a randomized, double-blinded, placebo-controlled, prospective study. Clinical orthopaedics and related research. 2013;471(1):64-75. doi: 10.1007/s11999-012-2596-9. PubMed PMID: 23011843; PubMed Central PMCID: PMC3528916.
37. Kang H JH, Lee JS, Yang JJ, Shin HY, Song KS. Early postoperative analgesic effects of a single epidural injection of ropivacaine administered preoperatively in posterior lumbar interbody spinal arthrodesis: a pilot randomized controlled trial. J Bone Joint Surg Am. 2013 Mar 6;95(5):393-9.
38. Saeed M AW, Rabbani S, Zahur S, Mahmood K, Andrabi SI, Butt HA, Chaudhry AM. The impact of preemptive ropivacaine in inguinal hernioplasty - A randomized controlled trial. Int J Surg. 2014 Dec 3;13C:76-9.
39. Yilmaz YF, Ozlugedik S, Titiz A, Tuncay A, Ozcan M, Unal A. Comparison of levo-bupivacaine and lidocaine for postoperative analgesia following septoplasty. Rhinology. 2008;46(4):289-91. PubMed PMID: 19145998.
2. Kanat A, Yazar U. Spinal surgery and neurosurgeon: quo vadis? Journal of neurosurgical sciences. 2013;57(1):75-9. PubMed PMID: 23584223.
3. Bina MS GA, Afshin H, Behnaz S, Kamyar G. Effect of body mass index on in patient rehabilitation outcomes after single-level discectomy. Neurosurg Qtly. 2013.
4. Maida G, Altruda C, Gatti M, Saletti A, Borrelli M, Sarubbo S. Two-year follow-up after microsurgical discectomy and dynamic percutaneous stabilization in degenerate and herniated lumbar disc: clinical and neuroradiological outcome. Journal of neurosurgical sciences. 2014;58(2):95-102. PubMed PMID: 24819486.
5. Simon J, McAuliffe M, Shamim F, Vuong N, Tahaei A. Discogenic low back pain. Physical medicine and rehabilitation clinics of North America. 2014;25(2):305-17. doi: 10.1016/j.pmr.2014.01.006. PubMed PMID: 24787335.
6. Dahl JB, Møiniche S. Pre-emptive analgesia. British Medical Bulletin. 2004;71(1):13-27. doi: 10.1093/bmb/ldh030.
7. Cohen SP, Raja SN. Prevention of chronic postsurgical pain: the ongoing search for the holy grail of anesthesiology. Anesthesiology. 2013;118(2):241-3. doi: 10.1097/ALN.0b013e31827d4129. PubMed PMID: 23340346.
8. Rundshagen I, Kochs E, Schulte am Esch J. Surgical stimulation increases median nerve somatosensory evoked responses during isoflurane-nitrous oxide anaesthesia. Br J Anaesth. 1995;75(5):598-602. PubMed PMID: 7577288.
9. Coull JA, Beggs S, Boudreau D, Boivin D, Tsuda M, Inoue K, et al. BDNF from microglia causes the shift in neuronal anion gradient underlying neuropathic pain. Nature. 2005;438(7070):1017-21. doi: 10.1038/nature04223. PubMed PMID: 16355225.
10. Bajwa SJ, Kaur J. Clinical profile of levobupivacaine in regional anesthesia: A systematic review. J Anaesthesiol Clin Pharmacol. 2013;29(4):530-9. doi: 10.4103/0970-9185.119172. PubMed PMID: 24249993; PubMed Central PMCID: PMCPMC3819850.
11. Katz J, Clarke H, Seltzer Z. Review article: Preventive analgesia: quo vadimus? Anesth Analg. 2011;113(5):1242-53. doi: 10.1213/ANE.0b013e31822c9a59. PubMed PMID: 21965352.
12. Rosero EB, Joshi GP. Preemptive, preventive, multimodal analgesia: what do they really mean? Plastic and reconstructive surgery. 2014;134(4 Suppl 2):85S-93S. doi: 10.1097/PRS.0000000000000671. PubMed PMID: 25255012.
13. Dionne R. Preemptive vs preventive analgesia: which approach improves clinical outcomes? Compendium of continuing education in dentistry. 2000;21(1):48, 51-4, 6. PubMed PMID: 11199689.
14. Kamaz A SO, Oksuz H,. Comparison of wound infiltration with bupivacaine and levobupivacaine for postoperative analgesia in patients operated for lumbar disc herniation. Anatol J Clin Investing. 2008;2(4):141-5.
15. Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science. 2000;288(5472):1765-9. PubMed PMID: 10846153.
16. Kehlet H, Dahl JB. The value of "multimodal" or "balanced analgesia" in postoperative pain treatment. Anesth Analg. 1993;77(5):1048-56. PubMed PMID: 8105724.
17. Ioannidis O, Anastasilakis CD, Varnalidis I, Paraskevas G, Malakozis SG, Gatzos S, et al. Intraperitoneal administration of local anesthetics in laparoscopic surgery: pharmacological, anatomical, physiological and pathophysiological considerations. Minerva chirurgica. 2013;68(6):599-612. PubMed PMID: 24193292.
18. Paul A, Mishra A, Bandyopadhyay K, Afzal M, Mookerjee S. Pre-emptive analgesia: Recent trends and evidences2013 September 1, 2013. 114-20 p.
19. McQuay HJ, Carroll D, Moore RA. Postoperative orthopaedic pain--the effect of opiate premedication and local anaesthetic blocks. Pain. 1988;33(3):291-5. PubMed PMID: 3419836.
20. Dagher C NN, Narchi P, Hage P, Antakly MC,. Regional anesthesia for lumbar microdiscectomy. J Med Liban. 2002 Sep-Dec;50(5-6):206-10.
21. Ejlersen E, Andersen HB, Eliasen K, Mogensen T. A comparison between preincisional and postincisional lidocaine infiltration and postoperative pain. Anesthesia and analgesia. 1992;74(4):495-8. PubMed PMID: 1482431.
22. Bashandy GM, Elkholy AH. Reducing postoperative opioid consumption by adding an ultrasound-guided rectus sheath block to multimodal analgesia for abdominal cancer surgery with midline incision. Anesthesiology and pain medicine. 2014;4(3):e18263. doi: 10.5812/aapm.18263. PubMed PMID: 25289373; PubMed Central PMCID: PMC4183078.
23. Mirza F, Carvalho B. Transversus abdominis plane blocks for rescue analgesia following Cesarean delivery: a case series. Canadian journal of anaesthesia = Journal canadien d'anesthesie. 2013;60(3):299-303. doi: 10.1007/s12630-012-9866-6. PubMed PMID: 23263981.
24. Kim HS, Lee HK, Jeong HS, Shin HW. Decreased postoperative pain after reduction of fractured nasal bones using a nerve block of the anterior ethmoidal nerve. International journal of oral and maxillofacial surgery. 2013;42(6):727-31. doi: 10.1016/j.ijom.2013.01.017. PubMed PMID: 23528745.
25. Burlacu CL, Buggy DJ. Update on local anesthetics: focus on levobupivacaine. Ther Clin Risk Manag. 2008;4(2):381-92. PubMed PMID: 18728849; PubMed Central PMCID: PMCPMC2504073.
26. Vadivelu N, Mitra S, Schermer E, Kodumudi V, Kaye AD, Urman RD. Preventive analgesia for postoperative pain control: a broader concept. Local Reg Anesth. 2014;7:17-22. doi: 10.2147/LRA.S62160. PubMed PMID: 24872720; PubMed Central PMCID: PMCPMC4012350.
27. Gurbet A, Bekar A, Bilgin H, Korfali G, Yilmazlar S, Tercan M. Pre-emptive infiltration of levobupivacaine is superior to at-closure administration in lumbar laminectomy patients. Eur Spine J. 2008;17(9):1237-41. doi: 10.1007/s00586-008-0676-z. PubMed PMID: 18425538; PubMed Central PMCID: PMC2527409.
28. Simon E, Bank J, Gal J, Siro P, Novak L, Fulesdi B, et al. Administration of preemptive analgesia by diclofenac to prevent acute postcraniotomy headache. Ideggyogyaszati szemle. 2012;65(9-10):302-6. PubMed PMID: 23126214.
29. Chan ZH, Balakrishnan V, McDonald A. Short versus long-acting local anaesthetic in open carpal tunnel release: which provides better preemptive analgesia in the first 24 hours? Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand. 2013;18(1):45-7. doi: 10.1142/S0218810413500081. PubMed PMID: 23413849.
30. Kim TH, Kang H, Choi YS, Park JM, Chi KC, Shin HY, et al. Pre- and intraoperative lidocaine injection for preemptive analgesics in laparoscopic gastrectomy: a prospective, randomized, double-blind, placebo-controlled study. Journal of laparoendoscopic & advanced surgical techniques Part A. 2013;23(8):663-8. doi: 10.1089/lap.2012.0542. PubMed PMID: 23614819.
31. Torun F, Mordeniz C, Baysal Z, Avci E, Togrul T, Karabag H, et al. Intraoperative perineural infiltration of lidocaine for acute postlaminectomy pain: preemptive analgesia in spinal surgery. Journal of spinal disorders & techniques. 2010;23(1):43-6. doi: 10.1097/BSD.0b013e318198793c. PubMed PMID: 20065867.
32. Mordeniz C, Torun F, Soran AF, Beyazoglu O, Karabag H, Cakir A, et al. The effects of pre-emptive analgesia with bupivacaine on acute post-laminectomy pain. Archives of orthopaedic and trauma surgery. 2010;130(2):205-8. doi: 10.1007/s00402-009-0961-2. PubMed PMID: 19727781.
33. Younessi OJ, Punnia-Moorthy A. Cardiovascular effects of bupivacaine and the role of this agent in preemptive dental analgesia. Anesthesia progress. 1999;46(2):56-62. PubMed PMID: 10853566; PubMed Central PMCID: PMC2148896.
34. Nesioonpour S, Akhondzadeh R, Pipelzadeh MR, Rezaee S, Nazaree E, Soleymani M. The effect of preemptive analgesia with bupivacaine on postoperative pain of inguinal hernia repair under spinal anesthesia: a randomized clinical trial. Hernia : the journal of hernias and abdominal wall surgery. 2013;17(4):465-70. doi: 10.1007/s10029-012-1007-1. PubMed PMID: 23104320.
35. Valente DS. Preemptive analgesia with bupivacaine in reduction mammaplasty: a prospective, randomized, double-blind, placebo-controlled trial. Plastic and reconstructive surgery. 2014;134(4):581-6. doi: 10.1097/PRS.0000000000000522. PubMed PMID: 24945948.
36. Goyal N, McKenzie J, Sharkey PF, Parvizi J, Hozack WJ, Austin MS. The 2012 Chitranjan Ranawat award: intraarticular analgesia after TKA reduces pain: a randomized, double-blinded, placebo-controlled, prospective study. Clinical orthopaedics and related research. 2013;471(1):64-75. doi: 10.1007/s11999-012-2596-9. PubMed PMID: 23011843; PubMed Central PMCID: PMC3528916.
37. Kang H JH, Lee JS, Yang JJ, Shin HY, Song KS. Early postoperative analgesic effects of a single epidural injection of ropivacaine administered preoperatively in posterior lumbar interbody spinal arthrodesis: a pilot randomized controlled trial. J Bone Joint Surg Am. 2013 Mar 6;95(5):393-9.
38. Saeed M AW, Rabbani S, Zahur S, Mahmood K, Andrabi SI, Butt HA, Chaudhry AM. The impact of preemptive ropivacaine in inguinal hernioplasty - A randomized controlled trial. Int J Surg. 2014 Dec 3;13C:76-9.
39. Yilmaz YF, Ozlugedik S, Titiz A, Tuncay A, Ozcan M, Unal A. Comparison of levo-bupivacaine and lidocaine for postoperative analgesia following septoplasty. Rhinology. 2008;46(4):289-91. PubMed PMID: 19145998.