[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].

OBJECTIVE

To assess and compare the analgesic efficacy of infiltrating the wound with ropivacaine or bupivacaine for postoperative pain after lumbar disk repair.

PATIENTS AND METHODS

A prospective, randomized double blind study of 45 patients undergoing elective surgery for herniated lumbar disk repair under general anesthesia. Before the surgical wound was closed, the paraspinal musculature and subcutaneous tissue were infused with 30 ml of 0.25% ropivacaine in group I (n = 15), 30 ml of 0.25% bupivacaine in group II (n = 15) or 30 ml of saline solution in group III (n = 15). Ketorolac for supplementary postoperative analgesia was made available through a patient-controlled intravenous system. We analyzed the degree of pain on a visual analog scale and level of pain relief on a simple descriptive scale.

RESULTS

No significant differences in demographic data, duration of surgery or amount of intraoperative fentanyl administered were observed among the groups. Mean time until the first request for analgesia was significantly longer in group II than in either groups I or III (164 +/- 53 min versus 68 +/- 31 and 38 +/- 14 min, respectively). Significantly less ketorolac was used in groups I and II than in group III (58 +/- 20 and 59 +/- 21 mg versus 118 +/- 32 mg). The mean scores on the visual analog scale were similar in all three groups.

CONCLUSIONS

In this study, infiltration of the surgical wound with 0.25% bupivacaine or 0.25% ropivacaine was similarly effective for treatment of pain after lumbar disk laminectomy.