Intraoperative fentanyl infiltration in single-level discectomy statistically reduces early postoperative pain: study
Lumbar disc prolapse is among the most frequent causes of Back pain resulting in surgery accounting for 5% of all lumbar surgeries. Patients who undergo fenestration discectomies have moderate to severe pain at surgical site, which lasts for 48 to 72 hours post surgery.
The study by Ravi Shankar evaluated the efficacy of intra-operative epidural fentanyl infiltration on post surgical analgesia following single-level fenestration discectomy and the adverse events that occurred among the groups.
60 patients were into two groups (Group A: Control & Group B: Drug).30 patients in the drug group—injected with intraoperative epidural fentanyl (1 mcg/kg weight) and 30 patients in the control group with placebo. All patients were followed up for the next 3 days. VAS scoring was used to assess post-operative pain and data on time to mobilization, the requirement for rescue analgesia (50 mg IV tramadol).
Key findings of the study were:
• A total of 37 males and 23 females participated in the trial.
• With the standard deviation of 8.6years, the study’s population average age in the placebo group was 46.6 yrs. Study participants in the drug group were 45.7 yrs old on average, with an 8.1-year standard deviation.
• Group A and Group B’s post-operative VAS scores at the first post-operative hour were statistically significant (value of p = 0.02).
• The respective times for mobilization were 19.6 and 18.4 hours.
The authors concluded that - ‘An intra-operative epidural fentanyl bolus dosage of 1 mcg/kg body weight was administered prior to the “wound closure during lumbar fenestration discectomy substantially decreased early postoperative pain” with little adverse reactions and a much shorter time to mobilization. We further suggest more trials to determine the effectiveness of fentanyl in managing pain following posterior spinal instrumentation procedures in a more extensive study population.’
Further reading:
Efficacy for epidural fenatnyl in single level fenestration lumbar discetomies: An randomised controlled trial
Ravi Shankar TC
Indian Journal of Orthopaedics Surgery 2024;10(4):324–328
https://doi.org/10.18231/j.ijos.2024.053
Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.
NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.