Korean J Pain.  2021 Apr;34(2):193-200. 10.3344/kjp.2021.34.2.193.

Continuous wound infiltration of ropivacaine for reducing of postoperative pain after anterior lumbar fusion surgery: a clinical retrospective comparative study

• Lee SM
• Yun DJ
• Lee SH
• Lee HC
• Joeng KH

• KMID: 2514419
• DOI: http://doi.org/10.3344/kjp.2021.34.2.193

Abstract

Background
Local anesthetic infiltration at the site of a surgical wound is commonly used to control postoperative pain. In this study, we examined the effectiveness of continuous local infiltration at an abdominal surgical site in patients undergoing anterior lumbar interbody fusion (ALIF) surgery.
Methods
Sixty-one patients who underwent ALIF surgery were enrolled. For thirtyone of them, a continuous local anesthetics infiltration system was used at the abdominal site. We collected data regarding the patients’ sleep quality; satisfaction with pain control after surgery; abilities to perform physical tasks and the additional application of opioids in the postoperative 48 hours.
Results
The On-Q system group showed reduced visual analogue scale scores for pain at the surgical site during rest and movement at 0, 12, 24, and 48 hours; and more was satisfied with pain control management at the first postoperative day (7.0 ± 1.2 vs. 6.0 ± 1.4; P = 0.003) and week (8.1 ± 1.6 vs. 7.0 ± 1.8; Background: Local anesthetic infiltration at the site of a surgical wound is commonly used to control postoperative pain. In this study, we examined the effectiveness of continuous local infiltration at an abdominal surgical site in patients undergoing anterior lumbar interbody fusion (ALIF) surgery.
Methods
Sixty-one patients who underwent ALIF surgery were enrolled. For thirtyone of them, a continuous local anesthetics infiltration system was used at the abdominal site. We collected data regarding the patients’ sleep quality; satisfaction with pain control after surgery; abilities to perform physical tasks and the additional application of opioids in the postoperative 48 hours.
Results
The On-Q system group showed reduced visual analogue scale scores for pain at the surgical site during rest and movement at 0, 12, 24, and 48 hours; and more was satisfied with pain control management at the first postoperative day (7.0 ± 1.2 vs. 6.0 ± 1.4; P = 0.003) and week (8.1 ± 1.6 vs. 7.0 ± 1.8; P = 0.010) than the control group. The number of additional patient-controlled analgesia (PCA) bolus and pethidine injections was lower in the On-Q group (PCA: 3.67 ± 1.35 vs. 4.60 ± 1.88; P = 0.049 and pethidine: 2.09 ± 1.07 vs. 2.73 ± 1.38;P = 0.032). Patients who used the On-Q system performed more diverse activity and achieved earlier ambulation than those in the control group.
Conclusions
Continuous wound infiltration with ropivacaine using an On-Q system may be effective for controlling postoperative pain after ALIF surgery. 0.010) than the control group. The number of additional patient-controlled analgesia (PCA) bolus and pethidine injections was lower in the On-Q group (PCA: 3.67 ± 1.35 vs. 4.60 ± 1.88; P = 0.049 and pethidine: 2.09 ± 1.07 vs. 2.73 ± 1.38; P = 0.032). Patients who used the On-Q system performed more diverse activity and achieved earlier ambulation than those in the control group.
Conclusions
Continuous wound infiltration with ropivacaine using an On-Q system may be effective for controlling postoperative pain after ALIF surgery.

Keyword

Activities of Daily Living; Analgesia; Patient-Controlled; Anesthesia; Local; Anesthetics; Local; Pain Management; Pain; Postoperative; Ropivacaine; Spinal Fusion; Surgical Wound

Figure

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  Fig. 1 The components of On-Q system (indwelling catheter and elastic pump, Halyard Health, Alpharetta, GA).

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  Fig. 2 Visual analoge scale (VAS) score for pain at the abdomanial site and back lesion at postoperative 1 week.

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  Fig. 3 Total postoperative patient-controlled analgesia (PCA) bolus and pethidine consumption in the postoperative 48 hours in the control (n = 30 patients) and On-Q (n = 31 patients) groups. Boxplots show the interquartile range (box). There were statistical differences between the two groups (P = 0.049, P = 0.032).

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