Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine

ÖZDEMİR, Nurdan; KUYTU, Turgut; BILGIN, NAZIFE HÜLYA; Bekar, Ahmet; GURBET, ALP

Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine

Alp GURBET, (Uludağ Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Bursa, Türkiye)

Ahmet BEKAR, (Uludağ Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Bursa, Türkiye)

Hülya BİLGİN, (Uludağ Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Bursa, Türkiye)

Nurdan ÖZDEMİR, (Uludağ Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Bursa, Türkiye)

Turgut KUYTU (Uludağ Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Bursa, Türkiye)

Turkish Neurosurgery

2 1

Yıl: 2014 Cilt: 24 Sayı: 1 Sayfa Aralığı: 48 - 53 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine

Öz:

AmAÇ: Hastalar lomber laminektomi sonrası şiddetli ağrı çekebilirler. Lokal anestezik ile yara infiltrasyonu postoperatif ağrı kontrolü için yararlı bir yöntemdir. Bu çalışmada, bupivakain ve levobupivakain ile yara infiltrasyonunun etkinliklerinin karşılaştırılması amaçlanmıştır.yÖntem ve GereÇler: 60 hasta randomize edilerek üç gruba ayrıldı: B grubu 20 ml %0,25 bupivakain ve 40 mg metilprednizolon ile kapatma öncesi yara infiltrasyonu; L grubu 20 ml %0,25 levobupivakain ve 40 mg metilprednizolon ile kapatma öncesi yara infiltrasyonu ve C Grubu 20 ml serum fizyolojik ile kapatma öncesi yara infiltrasyonu. Demografik veriler, vital bulgular, postoperatif ağrı skorları ve morfin kullanımı kaydedildi. BulGulAr: İlk analjezik istem zamanı kontrol grubunda diğer iki gruba göre daha kısa bulundu(p <0,001). 0-4, 4-12, 12-24 saatlik dilimlerde ve 24 saat sonunda en düşük toplam morfin tüketimi B grubunda tespit edildi ve grup L ile karşılaştırıldığında anlamlı farklılık saptanmadı. Ancak her iki grupta da morfin tüketiminin kontrol grubuna göre önemli ölçüde daha düşük olduğu bulundu(p <0,001). sOnuÇ: Verilerimiz bupivakain veya levobupivakain ile yara yerinin ameliyat öncesi infiltrasyonunun tek taraflı lomber laminektomi sonrası benzer etkin ağrı kontrolü sağladığını göstermektedir

Anahtar Kelime:

Konular: Cerrahi

Lomber Laminektomi Sonrası Postoperatif Ağrı Tedavisinde Preemptif Yara Yeri İnfiltrasyonu: Bupivakain ve Levobupivakain'in Karşılaştırılması

Öz:

AIm: Patients usually suffer significant pain after lumbar laminectomy. Wound infiltration with local anesthetics is a useful method for postoperative pain control. Our aim was to compare the efficacies of preemptive wound infiltration with bupivacaine and levobupivacaine. mAterIAl and methOds: 60 patients were randomized three groups as follows: Group L wound infiltration with 20 mL 0.25% levobupivacaine and 40 mg methylprednisolone just before wound closure; Group B wound infiltration with 20 mL 0.25% bupivacaine and 40 mg methylprednisolone before closure; Group C had this region infiltrated with 20 ml physiological saline. Demographic data, vital signs, postoperative pain scores and morphine usage were recorded. results: First analgesic requirement time was significantly shorter in the control group compared to other two groups (p<0.001). Group B had the lowest cumulative morphine consumption at the end of 24 hours within 0-4, 4-12 and 12-24 hours time intervals and the values were not significant when compared with Group L, however the consumption of both groups was significantly lower compared to the control group (p<0.001). COnClusIOn: Our data suggest that preoperative infiltration of the wound site with bupivacaine or levobupivacaine provides similarly effective pain control with reduced opiate dose after unilateral lumbar laminectomy.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Bay Nielsen M, Klarskov B, Bech K, Andersen J, Kehlet H: Levobupivacaine versus bupivacine as infiltration anesthesia in inguinal herniorraphy. Br J Anaesth 82:280-282, 1999
2. Bonica JJ: Postoperative pain. In: Bonica JJ (ed), The Management of Pain, 2nd ed. London: Lea & Febiger, 1990:461-462
3. Chadduck JB, Sneyd JR, Pobereskin LH: The role of bupivacaine in early postoperative pain control after lumbar decompression. J Neurosurg 90 (suppl):67-72, 1999
4. Crastein BN, Kimmel SC, Levin RI, et al: A mechanism for the antiinflammatory effects of corticosteroids: The glucocorticoid receptor regulates leukocyte adhesion to endothelial cells and expression of endothelialleukocyte adhesion molecule-1 and inter cellular adhesion molecule-1. Proc Natl Acad Sci USA 89:9991-9995, 1992
5. Ersaylı DT, Gurbet A, Bekar A, Uçkunkaya N, Bilgin H: Effects of perioperatively administered bupivacaine and bupivacaine-methylprednisolone on pain affter lumbar laminectomy. Spine 31(19):2221-2226, 2006
6. Foster RH, Markham A: Levobupivacaine: A review of its pharmacology and use as a local anesthetic. Drugs 59:551-579, 2000
7. Glasser RS, Knego RS, Delaskaw JB, Flesser RG: The perioperative use of corticosteroids and bupivacaine in the management of lumbar disc disease. J Neurosurg 78(3): 383-387, 1993
8. Gurbet A, Bekar A, Bilgin H, Kofralı G, Yılmazlar S, Tercan M: Pre-emptive infiltration of levobupivacaine is superior to at-closure administration in lumbar laminectomy patients. Eur Spine J 17(9):1237-1241, 2008
9. Gust R, Pecher S, Gust A, et al: Effect of patient-controlled analgesia onpulmonary complications after coronary artery bypass grafting. Crit Care Med 27:2218-2223, 1999
10. Jayr C, Mollie A, Bourgain JL, et al: Postoperative pulmonary complications: General anesthesia with postoperative paren-teral morphine. Surgery 104:57-63, 1988
11. King JS: Dexamethasone- a helpful adjunct in management after lumbar laminectomy. Neurosurgery 48(1):17-20, 1984
12. Kundra P, Gurnani A, Bhattacharya A: Preemptive epidural morphine for postoperative pain relief after lumbar laminec-tomy. Anesth Analg 85:153-158, 1997
13. Louizos AA, Hadzilia SJ, Leandros E, et al: Postoperative pain relief after laparoscopic cholecystectomy. Surg Endosc 19: 1503-1506, 2005
14. Mack PF, Hass D, Michael H, et al: Postoperative narcotic requirement after microscopic lumbar laminectomy is not affected by intraoperative ketorolac or bupivacaine. Spine 26: 658-661, 2001
15. Meena N, Cherian MD, Mohan P, Mathews MD, Mathew J, Chandy M: Local wound infiltration with bupivacaine in lumbar laminectomy. Surg Neurol 47: 120-123, 1997
16. Mirzai H, Tekin I, Alincak H: Perioperative use of corticosteroid and bupivacaine combination in lumbar disc surgery: A randomized controlled trial. Spine 27(4):343-346, 2002
17. Pflug AE, Murphy TM, Butler SH, et al: The effects of postop-erative analgesia on pulmonary therapy and complications. Anesthesiology 41:8-17, 1974
18. Ramsay MA, Savege TM, Simpson BR, et al: Controlled sedation with alphaxalone-alphadolone. BMJ 12:656-659, 1974
19. Ready LB. Acute postoperative pain. In: Miller RD (ed), Anesthesia, vol. I. New York: Churchill Livingstone, 1994: 2327-2335
20. Ready LB, Rawal N: Anesthesiology based acute pain services: A contemporary view. In: Regional Anesthesia and Analgesia. Philadelphia: Saunders, 1996:632-643
21. Yorukoglu D, Ates Y, Temiz H, et al: Comparison of low-dose intrathecal and epidural morphine and bupivacaine infiltration for postoperative pain control after surgery for lumbar disc disease. J Neurosurg Anesthesiol 17:129-133, 2005

APA	GURBET A, Bekar A, BILGIN N, ÖZDEMİR N, KUYTU T (2014). Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine. , 48 - 53.
Chicago	GURBET ALP,Bekar Ahmet,BILGIN NAZIFE HÜLYA,ÖZDEMİR Nurdan,KUYTU Turgut Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine. (2014): 48 - 53.
MLA	GURBET ALP,Bekar Ahmet,BILGIN NAZIFE HÜLYA,ÖZDEMİR Nurdan,KUYTU Turgut Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine. , 2014, ss.48 - 53.
AMA	GURBET A,Bekar A,BILGIN N,ÖZDEMİR N,KUYTU T Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine. . 2014; 48 - 53.
Vancouver	GURBET A,Bekar A,BILGIN N,ÖZDEMİR N,KUYTU T Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine. . 2014; 48 - 53.
IEEE	GURBET A,Bekar A,BILGIN N,ÖZDEMİR N,KUYTU T "Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine." , ss.48 - 53, 2014.
ISNAD	GURBET, ALP vd. "Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine". (2014), 48-53.

APA	GURBET A, Bekar A, BILGIN N, ÖZDEMİR N, KUYTU T (2014). Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine. Turkish Neurosurgery, 24(1), 48 - 53.
Chicago	GURBET ALP,Bekar Ahmet,BILGIN NAZIFE HÜLYA,ÖZDEMİR Nurdan,KUYTU Turgut Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine. Turkish Neurosurgery 24, no.1 (2014): 48 - 53.
MLA	GURBET ALP,Bekar Ahmet,BILGIN NAZIFE HÜLYA,ÖZDEMİR Nurdan,KUYTU Turgut Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine. Turkish Neurosurgery, vol.24, no.1, 2014, ss.48 - 53.
AMA	GURBET A,Bekar A,BILGIN N,ÖZDEMİR N,KUYTU T Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine. Turkish Neurosurgery. 2014; 24(1): 48 - 53.
Vancouver	GURBET A,Bekar A,BILGIN N,ÖZDEMİR N,KUYTU T Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine. Turkish Neurosurgery. 2014; 24(1): 48 - 53.
IEEE	GURBET A,Bekar A,BILGIN N,ÖZDEMİR N,KUYTU T "Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine." Turkish Neurosurgery, 24, ss.48 - 53, 2014.
ISNAD	GURBET, ALP vd. "Preemptive Wound Infiltration in Lumbar Laminectomy for postoperative pain: Comparison of Bupivacaine and Levobupivacaine". Turkish Neurosurgery 24/1 (2014), 48-53.