• J Neurosurg Anesthesiol · Oct 2012

    Randomized Controlled Trial

    Postoperative analgesic effects of wound infiltration with tramadol and levobupivacaine in lumbar disk surgeries.

    • Kadir Ozyilmaz, Hilal Ayoglu, Rahsan D Okyay, Serhan Yurtlu, Bengu Koksal, Volkan Hanci, Gulay Erdogan, and Isil O Turan.
    • Department of Anesthesiology and Reanimation, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey.
    • J Neurosurg Anesthesiol. 2012 Oct 1;24(4):331-5.

    BackgroundWound infiltration with local anesthetics may improve postoperative analgesia. Tramadol has been shown to have effects similar to those of local anesthetics. The purpose of this study was to investigate the effects of wound infiltration with levobupivacaine and tramadol on postoperative analgesia for lumbar discectomies.MethodsEighty adult patients who were scheduled to undergo elective lumbar discectomy operations were included in the study. Patients were randomly allocated to 4 groups: wound infiltration with 100 mg levobupivacaine (group L), 2 mg/kg tramadol (group T), 2 mg/kg tramadol plus 100 mg levobupivacaine (group LT), and saline (group C). Pain scores with the visual analog scale, patient-controlled analgesic consumption (pethidine), time to first analgesic treatment, and side effects were assessed during the postoperative period.ResultsThe time to first analgesia was earliest in group C (11.3±2.2 min), followed by group L (163.0±216.3 min) and group T (803.2±268.4 min) (P<0.001). None of the patients in group LT required postoperative analgesic supplementation, and the visual analog scale scores were <3 at all measurement times (P<0.05). Postoperative opioid consumption was 196.0±71.6 mg in group C, 129.0±78.3 mg in group L, and 37.0±35.4 mg in group T (P<0.001). The incidence of side effects was lower in group LT than in the other groups.ConclusionsWound infiltration with combined levobupivacaine and tramadol resulted in elimination of postoperative analgesic demand and reduction in the incidence of side effects. We conclude that infiltration of the wound site with combined levobupivacaine and tramadol provides significantly better analgesia compared with levobupivacaine or tramadol alone.

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