• Wei Jiang, Mengyu Fu, Wei Dong, Nian Zhou, Jieliang Shen, Xiaojun Zhang, and Jie Hao.
• Department of Orthopaedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
• Spine. 2022 Sep 15; 47 (18): 1328-1335.

Study DesignA prospective, randomized, double-blind controlled trial.ObjectiveTo explore the effect of multifunctional cocktail for bleeding and pain control after spinal fusion.Summary Of Background DataManaging postoperative bleeding and pain after spinal fusion remains a challenge. Topical application of tranexamic acid or anesthetic agents for bleeding or pain management just started recently, and the multifunctional cocktail for bleeding and pain control simultaneously after spinal fusion have never been published.MethodsNinety patients who underwent posterior spinal fusion were enrolled in this study. The multifunctional cocktail was injected into the incision before wound closure in the cocktail group. In the control group, an equal volume of normal saline was injected and a patient-controlled analgesic pump was used. Visual analogue scale score; opioid consumption; intraoperative, postoperative, hidden and total blood loss; volume of drainage, hematocrit levels of drainage; hemoglobin levels; and complications were compared between the two groups.ResultsThere were no differences in the visual analogue scale within 48 hours after surgery between the two groups. However, the opioid dosages in the control group were higher than those in the cocktail group. The postoperative blood loss, total blood loss, and hidden blood loss were lower in the cocktail group than in the control group. The drainage volume showed no differences between the two groups; however, the hematocrit level of drainage at 24 hours after surgery was lower in the cocktail group than in the control group. The hemoglobin level was higher in the cocktail group than in the control group at postoperative day 3. Thirteen patients with unbearable nausea and vomiting in the control group, whereas no complications in the cocktail group.ConclusionTopical application of a multifunctional cocktail that we designed provides an effective and safe method for reducing pain and bleeding after spinal fusion.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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