Efficacy of local wound infiltration analgesia with ropivacaine and dexmedetomidine in tubercular spine surgery – A pilot randomised double-blind controlled trial

Mohta, Medha; Rani, Anju; Sethi, Ankur; Jain, Anil K.

doi:10.4103/ija.ija_780_18

Cited by 11 publications

(13 citation statements)

References 18 publications

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“…Several cocktails with various adjuvants have been explored for administration in wound infiltration in spine surgeries. [ 5 6 ] Very few studies have compared the postoperative analgesic efficacy of TLIP block with that of wound infiltration with a local anaesthetic mixture. We hypothesised that TLIP block provided better analgesia than wound infiltration in posterior lumbar spine fusion surgeries.…”

Section: Introductionmentioning

confidence: 99%

Comparison of thoracolumbar interfascial plane block with local anaesthetic infiltration in lumbar spine surgeries – A prospective double-blinded randomised controlled trial

Pavithran¹,

Sudarshan²,

Eliyas³

et al. 2022

Indian J Anaesth

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Background and Aims: Posterior lumbar spine fusion surgeries are associated with severe postoperative pain necessitating a multimodal analgesic regime. Wound infiltration with local anaesthetic is an accepted modality for postoperative analgesia in spine surgeries. Thoracolumbar interfascial plane (TLIP) block is a novel technique being evaluated for providing analgesia in lumbar spine surgeries. This study aimed to compare the analgesic efficacy of TLIP block compared to that of wound infiltration with local anaesthetic in terms of time to request the first dose of rescue analgesic. Methods: Seventy-one patients scheduled for posterior lumbar spine fusion under general anaesthesia were included in this double-blinded randomised controlled trial. Preoperatively, patients were randomly allocated to receive either a TLIP block (TLIP group) or wound infiltration (LI group). The primary endpoint was the time of the first request for rescue analgesia. Secondary endpoints were the total tramadol consumption and pain and comfort scores measured at various time points in the 48-h postoperative period. The trial was terminated after second interim analysis as the analgesic benefit of TLIP was evident both clinically and statistically. Results: The median (interquartile range) duration of the time of the first request for rescue analgesia was 1440 (1290, 2280) min in the TLIP group and 340 (180, 360) min in the infiltration group; P value <.001. The mean tramadol consumption was significantly higher in the infiltration group compared to the TLIP group, with a P value <.001. Conclusion: TLIP block provided better postoperative analgesia than that provided by wound infiltration with local anaesthetic.

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Section: Introductionmentioning

confidence: 99%

Comparison of thoracolumbar interfascial plane block with local anaesthetic infiltration in lumbar spine surgeries – A prospective double-blinded randomised controlled trial

Pavithran¹,

Sudarshan²,

Eliyas³

et al. 2022

Indian J Anaesth

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“…They varied in their success rates, but all of them proved it as a safe technique. [ 14 15 16 ] However, several precautions and safety measures were still adopted. First, the dose used, of ropivacaine, was 30 mg (12 ml of 0.25%) and was within safe limits.…”

Section: Discussionmentioning

confidence: 99%

Ropivacaine instillation through subgaleal drain: A novel approach for acute post-craniotomy pain

Gehlaut¹,

Bala²,

Mittal³

et al. 2022

Indian J Anaesth

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Background and Aims: Post-craniotomy pain has often been overlooked and undertreated. Various classes of analgesic drugs have been used, not without limitations. Therefore, we planned to study the novel technique of wound instillation of ropivacaine through the surgical drain in patients undergoing supratentorial craniotomy to study its effect on post-craniotomy pain, analgesic requirement in the post-operative period along with the recovery profile of the patient and the side effects. Methods: This prospective, randomised, placebo-controlled, double-blinded study enroled 50 patients of either gender, scheduled to undergo elective craniotomy, under general anaesthesia. They were randomly divided into two groups and received either 12 ml of 0.25% ropivacaine (group R) or 12 ml of normal saline (group NS), through the subgaleal drain, after the closure of the dura. Pain scores were assessed at 1, 2, 4, 8 and 24 hours post-operatively. Student’s t-test was used for comparison of continuous variables and the Chi-square test or Fisher’s exact test was used for comparing the nominal categorical data. Results: The visual analogue scale score was higher in group NS than in group R, and the difference was statistically significant ( P = 0.012, 0.016, and 0.005 at 0, 1, and 2 post-operative hours, respectively). The difference in the mean emergence time in the two groups was 1.12 minutes ( P = 0.024). Conclusion: Single-time wound instillation of ropivacaine (12 ml of 0.25%) through surgical (subgaleal) drain during wound closure is an effective and simple technique for reducing post-operative pain and analgesic consumption and early emergence in neurosurgical patients undergoing supratentorial craniotomy.

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“…The efficacy of wound infiltration with ropivacaine, adrenaline, and dexmedetomidine was evaluated in spine surgery for Pott's spine patients and was observed to provide better postoperative analgesia with lower postoperative morphine requirement. [ 73 ] The intercostal or intrapleural block is recommended for postoperative pain relief in spine surgeries involving the anterior approach. [ 74 ]…”

Section: Postoperative Concernsmentioning

confidence: 99%

Perioperative concerns in Pott's spine: A review

Chilkoti

Jain

Mohta

et al. 2020

J Anaesthesiol Clin Pharmacol

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Pott's disease is the most common granulomatous spine infection caused by tubercle bacilli and is a common site of osseous tuberculosis, accounting for 50–60% of cases. The delay in establishing diagnosis and management results in complications such as spinal cord compression and spinal deformity. The aim of this narrative review is to discuss the perioperative concerns in patients for spine surgery. The literature source for this review was obtained via PubMed, Medline, Google Scholar, Cochrane database of systematic reviews, and textbooks until December 2019. On the literature search, we could not retrieve any review article specifically discussing the perioperative concerns of spinal tuberculosis. Therefore, the aim of the present narrative review is to discuss the perioperative concerns of patients for spine surgery along with the specific concerns related to spinal tuberculosis.

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Efficacy of local wound infiltration analgesia with ropivacaine and dexmedetomidine in tubercular spine surgery – A pilot randomised double-blind controlled trial

Cited by 11 publications

References 18 publications

Comparison of thoracolumbar interfascial plane block with local anaesthetic infiltration in lumbar spine surgeries – A prospective double-blinded randomised controlled trial

Comparison of thoracolumbar interfascial plane block with local anaesthetic infiltration in lumbar spine surgeries – A prospective double-blinded randomised controlled trial

Ropivacaine instillation through subgaleal drain: A novel approach for acute post-craniotomy pain

Perioperative concerns in Pott's spine: A review

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