The Use of Corticosteroids and Bupivacaine for Pain Management in Lumbar Disc Herniation Patient

Son, Hyeong Kweon; Moon, Chang Taek; Cho, Joon; Chang, Sang Geun

Abstract

The introduction of microdiscectomy in lumbar spine surgery has resulted in a significant decrease in postoperative pain and length of hospital stay. Intraoperative application of long-acting local anesthetic agents and corticosteroids during lumbar discectomy have been used for the management of postoperative pain. However, the efficacy of local anesthetic agents and corticosteroids has not been reported. This study evaluated 30 patients undergoing lumbar microdiscectomy. These patients were divided into three groups. Group I(10 patients) received intramuscular Depomedrol and intravenous Solumedrol at the start of the operation. A gelfoam soaked with Depomedrol was placed over the affected nerve root following discectomy. In addition, bupivacaine was infiltrated into the paraspinal musculature at the skin incision and during closure. Group II(10 patients) received intramuscular bupivacaine and used a saline-soaked gelfoam. Group III(10 patients) acted as a control group without corticosteroids and bupivacaine. Patients in Group I had a statistically significantly shorter hospital stay(8.9 days) compared to the control group(14.9 days). Patients in Group I required less postoperative narcotic analgesia than the other groups. A larger percentage of patients in Group I reported reduction of lower back pain and radicular pain until #POD 3 compared to other groups. These results indicate that the combination of long-acting local anesthetic agents and corticosteroids can reduce postoperative discomfort and hospital stay.