Local Anesthetic Infiltration to Prevent Postoperative Pain After Lumbar Surgery
Status:
Completed
Trial end date:
2010-08-01
Target enrollment:
Participant gender:
Summary
Posterior lumbar arthrodesis causes severe postoperative pain, hampering patients's
postoperative reconvalescence especially functional rehabilitation. Efficient and safe
methods for postoperative analgesia are, therefore, mandatory. The application of opioids are
the most frequently used therapies for postoperative pain relief but it very often results
side effects. Local anesthetic wound infiltration is widely recognized as a useful adjunct in
a multimodal approach to postoperative pain management. In the setting of spine surgery, a
single bolus administration of a local anesthetic is a useful method (with a reduction in
parenteral morphine consumption during the 48 first hours) but has a limited effect because
of its short duration of action. Prolonged administration through a multi-holed catheter
positioned by the surgeon at the end of the procedure could increase the duration of action
and may thereby improve the efficacy of local wound infiltration. Easy and effective, this
new modality of administration has expanded the indications for parietal infiltrations toward
major painful procedures.
We designed this study to determine whether local anesthetic (compared with saline solution)
continuous wound infiltration during the first two days after posterior lumbar arthrodesis on
degenerative spine, could improve postoperative analgesia at short-term but particularly at
mid-term (two months) and long-term (six months), in order to decrease postoperative lumbar
pains (resulting in best life quality, opioid consumption limited and rehabilitation
hastened) and postoperative hyperalgesia areas. The postoperative analgesic and
antihyperalgesic efficacies; the postoperative rehabilitation at mid-term and long term, and
the safety of opioid administration and multi-holed parietal catheter will be compared in the
two groups (control and study).