DEXAMETHASONE AS ADJUVANT TO ROPIVACAINE IN WOUND INFILTRATION FOR POSTOPERATIVE ANALGESIA FOLLOWING SPINAL SURGERY: A RANDOMIZED, DOUBLE-BLINDED, CONTROLLED TRIAL | ||||
| Pan Arab Journal of Neurosurgery | ||||
| Articles in Press, Accepted Manuscript, Available Online from 20 December 2023 PDF (857.89 K) | ||||
| Document Type: Original Articles | ||||
| DOI: 10.21608/pajn.2023.210451.1094 | ||||
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| Authors | ||||
Emna Mili1; Imen Soyeh2; Atef Ben nsir3; Besma Gafsi4; lobna mahjoub3; Gaith Zakraoui5; Kais Maamri   3; Samir Toumi4; Faouzi Ben Salem6; Mehdi Darmoul7
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| 1Departement of anesthesiology, Faculty of medecine of Monastir, University of Monastir, Monastir, Tunisia | ||||
| 2Departement of anesthesiology, Fculty of medecine of Monastir, University of Monastir (Fattouma Bourguiba University Hospital ) Monastir Tunisia | ||||
| 3Fattouma Bourguiba University Hospital Rue Farhat HACHAD Monastir Tunisia 5000 | ||||
| 4Departement of anesthesiology, Faculty of medecine of Monastir, University of Monastir (Fattouma Bourguiba University Hospital), Monastir,Tunisia | ||||
| 5Departement of anesthesiology, Faculty of medecine of Monastir, University of Monastir ( Fattouma Bourguiba University Hospital), Monastir, Tunisia | ||||
| 6Departement of anesthesiology,Faculty of medecine of Monastir, University of Monastir ( Fattouma Bourguiba University hospital), Monastir , Tunisia | ||||
| 7Departement of neurosurgery, Faculty of medecine of Monastir, University of Monastir (Fattouma Bourguiba University Hospital) Monastir, Tunisia | ||||
| Abstract | ||||
| Introduction Pain following spinal surgery, can limit early mobility, and increase the risk of chronic pain. This trial examines the analgesic effects of dexamethasone as an adjuvant to ropivacaine in wound infiltration after lumbar surgery. Materials and methods In this study, we randomly assigned sixty patients undergoing lumbar laminectomy and/or osteosynthesis into two groups of 30 patients each. The control group received only Ropivacaine in the wound infiltration, while the intervention group received Ropivacaine with the addition of dexamethasone .Both groups were administered patient-controlled analgesia (PCA) with morphine for self-medication. Results Postoperatively, a blinded evaluator assessed pain at H0, recorded the assessment of surgical scar pain using the Visual Analog Scale (VAS) at 4, 6, 12, 24, and 48 hours, as well as the time to the first opioid request, cumulative morphine consumption, opioid-related side effects, and length of stay. The RD-group had significantly lower VAS scores for postoperative pain within 24 hours compared to the R-group (P<0.005). However, no significant difference was observed between the two groups for pain reported at 48 hours. The RD-group exhibited significantly lower opioid requirements within the first 48 hours (P<0.001) and a significantly longer time to first analgesic demand of PCA compared to the control group (P<0.05). Conclusion Our study suggests that the addition of Dexamethasone to Ropivacaine in wound infiltration for patients undergoing lumbar laminectomy and/or osteosynthesis can lead to a reduction in morphine consumption, improved analgesia, and a shorter length of hospitalization | ||||
| Keywords | ||||
| Pain management; lumbar laminectomy; osteosynthesis | ||||
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