• World Neurosurg · Aug 2019

    Randomized Controlled Trial Comparative Study

    Comparison of Haemostatic Gelatin Sponge Impregnated with Ropivacaine versus Normal Saline applied on the Transverse Process of the Operated Vertebrae on Post-Operative Pain in Patients Undergoing Spinal Instrumentation Surgery: A Randomized Clinical Trial.

    • Maroun B Ghabach, Nakhle E Mhanna, Morad R Abou Al Ezz, Georges N Mezher, Monique J Chammas, and Marc M Ghabach.
    • Department of Anesthesiology, Rosary Sisters Hospital, Gemayze, Beirut, Lebanon. Electronic address: maroun_ghabash@yahoo.com.
    • World Neurosurg. 2019 Aug 1; 128: e1126-e1130.

    BackgroundProtocols for effective postoperative pain control in patients undergoing spinal surgery are not standardized. In our study, we compared the effects of hemostatic absorbable gelatin sponge impregnated with ropivacaine versus normal saline when applied to the transverse process of the operated vertebrae on the postoperative pain following instrumentation spine surgery.MethodsA prospective double-blind randomized study was conducted on 30 patients undergoing spine surgery. At the end of surgery, the hemostatic gelatin sponge was applied by the surgeon on the transverse process of the operated vertebra containing either ropivacaine 0.5% or normal saline NaCl 0.9. Pain was assessed using the visual analog scale (VAS) every 4 hours for 48 hours postoperatively in the 2 groups (ropivacaine vs. normal saline). The total amount of postoperative opioid use was also recorded.ResultsThe VAS score was significantly lower in patients receiving hemostatic gelatin sponge impregnated with local anesthetics as compared with patients receiving gelatin sponge impregnated with normal saline 48 hours postoperatively; the mean total dose of meperidine given in the first 48 hours postoperatively was significantly lower (53.5 ± 51.0 mg) in patients receiving gelatin sponge impregnated with local anesthetics as compared with patients receiving hemostatic gelatin sponge impregnated with normal saline (140.5 ± 102 mg).ConclusionsUse of intraoperative hemostatic gelatin sponge impregnated with ropivacaine applied on the transverse process of the operated vertebrae intraoperatively resulted in decreasing the postoperative pain in patients undergoing lumbar instrumentation surgery as manifested by the decrease in the VAS score and the total dose of opioids.Copyright © 2019 Elsevier Inc. All rights reserved.

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