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Dexamethasone added to local lidocaine for infiltration along the spinal-epidural needle pathway decreases incidence and severity of backache after gynecological surgery.

Gao W, Ren Y, Cui GX - Med. Sci. Monit. (2015)

Bottom Line: The VAS score for back pain on the first and second day and first and second month, were significantly lower in the DL group than the L group (P=0.0028, P=0.017; P<0.001, both), but there were no significant differences on the third day and sixth month.Fentanyl consumption in the first 3 postoperative days was significantly lower in the DL group than in the L group (P<0.001).The incidence of back pain during the first, second, and sixth month in patients who did not have preoperative lumbago were significantly lower in the DL group than in the L group (P<0.001, both).

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China (mainland).

ABSTRACT

Background: The aim of this study was to evaluate the effect of dexamethasone added to local lidocaine infiltration on incidence and severity of backache after combined spinal-epidural anesthesia for gynecological surgery.

Material and methods: We randomly allocated 160 patients to receive either local lidocaine infiltration along the pathway of the spinal-epidural needle (Group L) or local dexamethasone and lidocaine infiltration (Group DL). The incidence and scores for back pain were evaluated on the first, second, and third day (acute lumbago) and first, second, and sixth month (chronic lumbago) after surgery. Fentanyl consumption for management of back pain was recorded.

Results: The incidence of acute, subacute, and chronic back pain was significantly lower in the DL group than the L group (P<0.05 for all comparisons). The VAS score for back pain on the first and second day and first and second month, were significantly lower in the DL group than the L group (P=0.0028, P=0.017; P<0.001, both), but there were no significant differences on the third day and sixth month. Fentanyl consumption in the first 3 postoperative days was significantly lower in the DL group than in the L group (P<0.001). The incidence of back pain during the first, second, and sixth month in patients who did not have preoperative lumbago were significantly lower in the DL group than in the L group (P<0.001, both).

Conclusions: Addition of dexamethasone to local lidocaine infiltration effectively decreases the incidence and severity of back pain after combined spinal-epidural anesthesia implemented for gynecological surgery.

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Related in: MedlinePlus

Summation of fentanyl for back pain during the postoperative 3 days. Group L, lidocaine group; Group DL, local dexamethasone plus lidocaine group. Values are expressed as the mean ± standard deviation. * P<0.05.
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f4-medscimonit-21-821: Summation of fentanyl for back pain during the postoperative 3 days. Group L, lidocaine group; Group DL, local dexamethasone plus lidocaine group. Values are expressed as the mean ± standard deviation. * P<0.05.

Mentions: Regarding pain severity, at D1 and D2 timepoints, the VAS scores were significantly lower in group DL. At D3, the VAS score in group DL was lower than in group L, but the difference was not significant. At M1 and M2 timepoints, the VAS scores were significantly lower in group DL but there was no significant difference at M6. During the first post-operative day, there were 11 patients in group L and 4 patients in group DL who requested fentanyl for lumbar pain. In the second post-operative day, there were 4 patients in group L who requested fentanyl for lumbar pain. In this study, the third anesthetist injected fentanyl for back pain in the 2 groups at any time when VAS score was over 4, not only at the postoperative 24, 48, or 72 hour timepoint. Therefore, the VAS score was lower than 4 when we assessed the patients at postoperative hours24, 48, or 72 hour. The total consumption of fentanyl was significantly lower in group DL than group L during the postoperative 3 days (Figure 4). After discharge from hospital, no patient needed additional analgesics for lumbar pain.


Dexamethasone added to local lidocaine for infiltration along the spinal-epidural needle pathway decreases incidence and severity of backache after gynecological surgery.

Gao W, Ren Y, Cui GX - Med. Sci. Monit. (2015)

Summation of fentanyl for back pain during the postoperative 3 days. Group L, lidocaine group; Group DL, local dexamethasone plus lidocaine group. Values are expressed as the mean ± standard deviation. * P<0.05.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4374485&req=5

f4-medscimonit-21-821: Summation of fentanyl for back pain during the postoperative 3 days. Group L, lidocaine group; Group DL, local dexamethasone plus lidocaine group. Values are expressed as the mean ± standard deviation. * P<0.05.
Mentions: Regarding pain severity, at D1 and D2 timepoints, the VAS scores were significantly lower in group DL. At D3, the VAS score in group DL was lower than in group L, but the difference was not significant. At M1 and M2 timepoints, the VAS scores were significantly lower in group DL but there was no significant difference at M6. During the first post-operative day, there were 11 patients in group L and 4 patients in group DL who requested fentanyl for lumbar pain. In the second post-operative day, there were 4 patients in group L who requested fentanyl for lumbar pain. In this study, the third anesthetist injected fentanyl for back pain in the 2 groups at any time when VAS score was over 4, not only at the postoperative 24, 48, or 72 hour timepoint. Therefore, the VAS score was lower than 4 when we assessed the patients at postoperative hours24, 48, or 72 hour. The total consumption of fentanyl was significantly lower in group DL than group L during the postoperative 3 days (Figure 4). After discharge from hospital, no patient needed additional analgesics for lumbar pain.

Bottom Line: The VAS score for back pain on the first and second day and first and second month, were significantly lower in the DL group than the L group (P=0.0028, P=0.017; P<0.001, both), but there were no significant differences on the third day and sixth month.Fentanyl consumption in the first 3 postoperative days was significantly lower in the DL group than in the L group (P<0.001).The incidence of back pain during the first, second, and sixth month in patients who did not have preoperative lumbago were significantly lower in the DL group than in the L group (P<0.001, both).

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China (mainland).

ABSTRACT

Background: The aim of this study was to evaluate the effect of dexamethasone added to local lidocaine infiltration on incidence and severity of backache after combined spinal-epidural anesthesia for gynecological surgery.

Material and methods: We randomly allocated 160 patients to receive either local lidocaine infiltration along the pathway of the spinal-epidural needle (Group L) or local dexamethasone and lidocaine infiltration (Group DL). The incidence and scores for back pain were evaluated on the first, second, and third day (acute lumbago) and first, second, and sixth month (chronic lumbago) after surgery. Fentanyl consumption for management of back pain was recorded.

Results: The incidence of acute, subacute, and chronic back pain was significantly lower in the DL group than the L group (P<0.05 for all comparisons). The VAS score for back pain on the first and second day and first and second month, were significantly lower in the DL group than the L group (P=0.0028, P=0.017; P<0.001, both), but there were no significant differences on the third day and sixth month. Fentanyl consumption in the first 3 postoperative days was significantly lower in the DL group than in the L group (P<0.001). The incidence of back pain during the first, second, and sixth month in patients who did not have preoperative lumbago were significantly lower in the DL group than in the L group (P<0.001, both).

Conclusions: Addition of dexamethasone to local lidocaine infiltration effectively decreases the incidence and severity of back pain after combined spinal-epidural anesthesia implemented for gynecological surgery.

Show MeSH
Related in: MedlinePlus