Intraoperative fentanyl infiltration in single-level discectomy statistically reduces early postoperative pain: study

Written by Dr Supreeth D R Published On 2025-02-04T21:00:32+05:30 | Updated On 5 Feb 2025 12:22 PM IST

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.’

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.