Analgesia Following Lumbar Discectomy

Zagazig University

Status: Not yet enrolling

Conditions: Local Infiltration; Analgesia; Disk Herniated Lumbar

Treatments: Procedure: Local wound infiltration; Procedure: Retrolaminar plane block

Study type: Interventional

Funder types: Other

Identifiers

NCT06869889

Spine surgeries Analgesia

Details and patient eligibility

About

Lumbar discectomy surgeries are often the last option for patients with disc herniation who do not improve with conservative treatments. However, these procedures can lead to significant perioperative pain that may become chronic without effective management. While intravenous opioids are commonly used for pain control, they can complicate recovery and pose risks like dependence. In contrast, regional anesthetic techniques offer advantages such as quicker recovery, better postoperative pain relief, and reduced opioid use, which can lead to shorter hospital stays. Our study aims to compare the effectiveness of the retrolaminar block with local wound infiltration for pain management following posterior lumbar discectomy surgeries, potentially improving patient outcomes.

Full description

Lumbar discectomy surgeries are the last resort for disc herniation patients not responding to conservative treatment. However, these surgeries are associated with annoying perioperative pain that could be severe and progress to chronic pain if not managed properly. There is no consensus regarding the best approach for postoperative pain management following spine surgeries. Intravenous opioids are still the primary agents used for perioperative pain control, which can complicate the postoperative recovery with the associated side effects and the risk of opioid dependence. Regional anesthetic techniques for spine surgeries allow rapid recovery, prolonged postoperative analgesia, and less opioid consumption, which decreases hospital stays. The current study will compare the analgesic efficacy of the retrolaminar block to the local wound infiltration following posterior lumbar discectomy surgeries.

Enrollment: 120 estimated patients

Sex: All

Ages: 21 to 64 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Elective surgical decompression of single-level herniated lumbar disc.

Exclusion criteria

• Opioid-dependent patients.
• Known hypersensitivity to bupivacaine.
• Diabetic patients.
• Uncooperative patient or with altered mental status.
• Previous spine surgery.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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120 participants in 2 patient groups

Retrolaminar block group

Active Comparator group

Description:

After confirming the correct position using imaging with a C-Arm device, the patient will receive a retrolaminar block on both sides at the level of the operated disc.

Treatment:

Procedure: Retrolaminar plane block

Local Infiltration group

Active Comparator group

Description:

The patient will receive local wound infiltration following the completion of the surgical steps with the patient in the prone position using a local anesthetic solution, tailored to the specific conditions surrounding the incision site.

Treatment:

Procedure: Local wound infiltration