Abstract
We compared the analgesic effect of diclofenac suppository, bupivacaine or morphine infiltration into surgical wounds in patients who underwent lumbar spinal surgery.
Thirty-two patients who were scheduled for herniotomy or fenestration under general anesthesia were assigned randomly to four groups: D-group (n=7) was administered with 50mg diclofenac suppository after induction of general anesthesia. LB-group (n=8) received infiltration into surgical wound of 10ml of 0.25% bupivacaine before wound closure. HB-group (n=9) received infiltration of 10ml of 0.5% bupivacaine and M-group (n=8) received 3mg of morphine in 9.7ml of saline in the same manner as in the LB-group. Postoperative pain was assessed using pain score (0: none-4: severe) at 0, 1, 3, 6, 24 and 48 hours during the postoperative periods. Duration of postoperative analgesia, amount of supplemental analgesics used over the 24-h and 48-h periods and side effects were evaluated.
Pain scores in LB-group and HB-group were lower than those of M-group when patients arrived in the ICU. Duration of periods of postoperative analgesia in HB-group and D-group were longer than those of M-group. No significant differences were found among the groups in the frequency of postoperative analgesics administered over the 24-h and 48-h period. In the HB-group, however, the percentage of patients who did not require supplemental analgesics throughout 24-h and 48-h postoperative hours was greater than that of M-group. No significant side effects were observed.
Infiltration of surgical wound with 0.5% bupivacaine before wound closure was useful and safe for postoperative pain relief following lumber spinal sugery.
