Local infiltration analgesia with ropivacaine in acute fracture of thoracolumbar junction surgery

Orthop Traumatol Surg Res. 2017 Apr;103(2):291-294. doi: 10.1016/j.otsr.2016.11.012. Epub 2016 Dec 28.

Abstract

Study design: Retrospective study.

Introduction: Local infiltration analgesia is effective in many surgeries as knee arthroplasty, but the analgesic efficacy of local infiltration analgesia with ropivacaine in trauma spine surgery in T10 to L2 has not been clarified. We conducted a trial to assess the analgesic efficacy of intraoperative local infiltration analgesia (LIA) with ropivacaine.

Objective: The aim of the present study was to clarify the effect of intraoperative local infiltration analgesia with ropivacaine on postoperative pain for patients undergoing thoracolumbar junction fracture surgery.

Methods: In a retrospective study, in 76 patients undergoing spine surgery for thoracolumbar junction fracture, 20ml of ropivacaine 7.5% (n R group=38) was infiltrated using a systematic technique, or no infiltration was realized (n M group=38). We assessed postoperative pain with Visual Analogue Scale (VAS) and morphine consumption in the 24 first hours.

Results: VAS pain score upon awakening and at 2hours postoperatively were significantly lower in the ropivacaine group (P=0.01 and P=0.002). Rescue opioid requirement during the 24 first hours were about 50% lower in the ropivacaine group (P=0.01). No local or systemic side effects were observed.

Conclusion: Intraoperative LIA with ropivacaine in thoracolumbar junction fracture surgery may have an analgesic effect in postoperative pain control (24hours) with a reduction of VAS and morphine consumption.

Keywords: Local infiltration analgesia; Morphine consumption; Postoperative pain treatment; Spine surgery; Thoracolumbar junction fracture.

MeSH terms

  • Adult
  • Amides*
  • Analgesia / methods*
  • Analgesics, Opioid / therapeutic use
  • Anesthesia, Local
  • Anesthetics, Local*
  • Double-Blind Method
  • Female
  • Humans
  • Intraoperative Care
  • Lumbar Vertebrae / injuries
  • Male
  • Middle Aged
  • Morphine / therapeutic use
  • Pain Measurement
  • Pain, Postoperative / etiology
  • Pain, Postoperative / prevention & control*
  • Retrospective Studies
  • Ropivacaine
  • Spinal Fractures / surgery*
  • Thoracic Vertebrae / injuries

Substances

  • Amides
  • Analgesics, Opioid
  • Anesthetics, Local
  • Morphine
  • Ropivacaine