Dexamethasone as Adjuvant to Ropivacaine in Wound Infiltration for Postoperative Analgesia Following Spinal Surgery
Status:
Completed
Trial end date:
2023-03-05
Target enrollment:
Participant gender:
Summary
Introduction: Improving postoperative pain management after spinal surgery is a significant
challenge for surgeons and anesthesiologists. Pain following spinal surgery, can lead to
significant morbidity, limit early mobility, and increase the risk of chronic pain. This
trial examines the analgesic effects of dexamethasone as an adjuvant to ropivacaine in wound
infiltration after lumbar surgery.
Methods: In this study, we randomly assigned sixty patients undergoing lumbar laminectomy
and/or osteosynthesis into two groups of 30 patients each. The control group (R-group)
received only Ropivacaine (150 mg of Ropivacaine 7.5% (20 ml) added to 2 ml of normal saline
in the wound infiltration), while the intervention group (RD-group) received Ropivacaine with
the addition of dexamethasone (150 mg of Ropivacaine 7.5% (20 ml) added to 8 mg of
dexamethasone in the wound infiltration). Both groups were administered patient-controlled
analgesia (PCA) with morphine for self-medication.
Postoperatively, a blinded evaluator assessed pain at H0, recorded the assessment of surgical
scar pain using the Visual Analog Scale (VAS) at 4, 6, 12, 24, and 48 hours, as well as the
time to the first opioid request, cumulative morphine consumption, opioid-related side
effects, and length of stay. All patients were scheduled for a 3-month follow-up call to
monitor chronic pain progression.