Effect of intradiscal local anesthetic injection on intraoperative pain during percutaneous transforaminal endoscopic discectomy: A retrospective study
Objective: Patients undergoing percutaneous transforaminal endoscopic discectomy (PTED) often complain of unbearable intraoperative pain. This study is to observe clinical effectiveness and safety of intradiscal local anesthetic injection for intraoperative pain relief. Methods: Total 268 patients w...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-07-01
|
| Series: | Asian Journal of Surgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958422014348 |
| _version_ | 1797790888395538432 |
|---|---|
| author | Le Duan Jing-Yue Zhang Jia-Hang Zhang Ji-Yu Kang Hua-Cheng Zhou |
| author_facet | Le Duan Jing-Yue Zhang Jia-Hang Zhang Ji-Yu Kang Hua-Cheng Zhou |
| author_sort | Le Duan |
| collection | DOAJ |
| description | Objective: Patients undergoing percutaneous transforaminal endoscopic discectomy (PTED) often complain of unbearable intraoperative pain. This study is to observe clinical effectiveness and safety of intradiscal local anesthetic injection for intraoperative pain relief. Methods: Total 268 patients who underwent PTED were analyzed. Patients were divided into intradiscal saline injection group (group C) and intradiscal local anesthetic injection group (group L). Intradiscal mixture was consisted of saline or local anesthetic + methylene blue, the amount of injected mixture was 3 mL. Demographic data, visual analog scale (VAS) and Quebec Back Pain Disability Scale (QBPDS) scores, mean arterial pressure (MAP) and heart rate (HR), total dosage of fentanyl, satisfaction rate of anesthesia and complications were collected at different timepoints. Results: Compared with group C (3.94 ± 0.57), there was a significant reduction of VAS in group L (2.83 ± 0.28) during fibrous annular operation phase (T2). Group L had a lower total dosage of fentanyl (71 [63, 78] μg) and a higher anesthesia satisfaction rate (95.3%) than group C (82 [70, 132] μg and 73.6%, respectively) (P < 0.001). MAP and HR were lower in group L than in group C at T2 (P < 0.001). Baseline characteristics and QBPDS scores showed no meaningful intergroup differences. Four cases of complications were reported in this study. Conclusion: Intradiscal local anesthetic injection significantly alleviated intraoperative back pain and increased the satisfaction rate of anesthesia, without severe complications, indicating that this technique is a feasible method for intraoperative back pain relief for patients undergoing PTED. |
| first_indexed | 2024-03-13T02:10:55Z |
| format | Article |
| id | doaj.art-4b9bddcae6b04372bdde945defea36e0 |
| institution | Directory Open Access Journal |
| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-03-13T02:10:55Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj.art-4b9bddcae6b04372bdde945defea36e02023-07-01T04:33:49ZengElsevierAsian Journal of Surgery1015-95842023-07-0146726822688Effect of intradiscal local anesthetic injection on intraoperative pain during percutaneous transforaminal endoscopic discectomy: A retrospective studyLe Duan0Jing-Yue Zhang1Jia-Hang Zhang2Ji-Yu Kang3Hua-Cheng Zhou4Department of Pain Medicine, the Fourth Affiliated Hospital of Harbin Medical University, Harbin, China; Department of Anesthesiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, ChinaDepartment of Pain Medicine, the Fourth Affiliated Hospital of Harbin Medical University, Harbin, China; Department of Pain Medicine, the First Affiliated Hospital of Harbin Medical University, Harbin, ChinaDepartment of Pain Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin, ChinaDepartment of Pain Medicine, the Fourth Affiliated Hospital of Harbin Medical University, Harbin, ChinaDepartment of Pain Medicine, the Fourth Affiliated Hospital of Harbin Medical University, Harbin, China; Corresponding author. Department of Pain Medicine, the Fourth Affiliated Hospital of Harbin Medical University, No.37, Yiyuan Street, Nangang District, Harbin, 150001, Heilongjiang Province, China.Objective: Patients undergoing percutaneous transforaminal endoscopic discectomy (PTED) often complain of unbearable intraoperative pain. This study is to observe clinical effectiveness and safety of intradiscal local anesthetic injection for intraoperative pain relief. Methods: Total 268 patients who underwent PTED were analyzed. Patients were divided into intradiscal saline injection group (group C) and intradiscal local anesthetic injection group (group L). Intradiscal mixture was consisted of saline or local anesthetic + methylene blue, the amount of injected mixture was 3 mL. Demographic data, visual analog scale (VAS) and Quebec Back Pain Disability Scale (QBPDS) scores, mean arterial pressure (MAP) and heart rate (HR), total dosage of fentanyl, satisfaction rate of anesthesia and complications were collected at different timepoints. Results: Compared with group C (3.94 ± 0.57), there was a significant reduction of VAS in group L (2.83 ± 0.28) during fibrous annular operation phase (T2). Group L had a lower total dosage of fentanyl (71 [63, 78] μg) and a higher anesthesia satisfaction rate (95.3%) than group C (82 [70, 132] μg and 73.6%, respectively) (P < 0.001). MAP and HR were lower in group L than in group C at T2 (P < 0.001). Baseline characteristics and QBPDS scores showed no meaningful intergroup differences. Four cases of complications were reported in this study. Conclusion: Intradiscal local anesthetic injection significantly alleviated intraoperative back pain and increased the satisfaction rate of anesthesia, without severe complications, indicating that this technique is a feasible method for intraoperative back pain relief for patients undergoing PTED.http://www.sciencedirect.com/science/article/pii/S1015958422014348Intradiscal injectionIntraoperative painLocal anestheticPercutaneous transforaminal endoscopic discectomy |
| spellingShingle | Le Duan Jing-Yue Zhang Jia-Hang Zhang Ji-Yu Kang Hua-Cheng Zhou Effect of intradiscal local anesthetic injection on intraoperative pain during percutaneous transforaminal endoscopic discectomy: A retrospective study Asian Journal of Surgery Intradiscal injection Intraoperative pain Local anesthetic Percutaneous transforaminal endoscopic discectomy |
| title | Effect of intradiscal local anesthetic injection on intraoperative pain during percutaneous transforaminal endoscopic discectomy: A retrospective study |
| title_full | Effect of intradiscal local anesthetic injection on intraoperative pain during percutaneous transforaminal endoscopic discectomy: A retrospective study |
| title_fullStr | Effect of intradiscal local anesthetic injection on intraoperative pain during percutaneous transforaminal endoscopic discectomy: A retrospective study |
| title_full_unstemmed | Effect of intradiscal local anesthetic injection on intraoperative pain during percutaneous transforaminal endoscopic discectomy: A retrospective study |
| title_short | Effect of intradiscal local anesthetic injection on intraoperative pain during percutaneous transforaminal endoscopic discectomy: A retrospective study |
| title_sort | effect of intradiscal local anesthetic injection on intraoperative pain during percutaneous transforaminal endoscopic discectomy a retrospective study |
| topic | Intradiscal injection Intraoperative pain Local anesthetic Percutaneous transforaminal endoscopic discectomy |
| url | http://www.sciencedirect.com/science/article/pii/S1015958422014348 |
| work_keys_str_mv | AT leduan effectofintradiscallocalanestheticinjectiononintraoperativepainduringpercutaneoustransforaminalendoscopicdiscectomyaretrospectivestudy AT jingyuezhang effectofintradiscallocalanestheticinjectiononintraoperativepainduringpercutaneoustransforaminalendoscopicdiscectomyaretrospectivestudy AT jiahangzhang effectofintradiscallocalanestheticinjectiononintraoperativepainduringpercutaneoustransforaminalendoscopicdiscectomyaretrospectivestudy AT jiyukang effectofintradiscallocalanestheticinjectiononintraoperativepainduringpercutaneoustransforaminalendoscopicdiscectomyaretrospectivestudy AT huachengzhou effectofintradiscallocalanestheticinjectiononintraoperativepainduringpercutaneoustransforaminalendoscopicdiscectomyaretrospectivestudy |