High-volume, multilevel local anesthetics–Epinephrine infiltration in kyphoscoliosis surgery: Intra and postoperative analgesia
Background and Aims: Local anesthetic (LA) infiltration is one of the analgesic techniques employed during scoliosis correction surgery. However, its efficacy is controversial. In the present study for optimizing analgesia using the infiltration technique, we proposed two modifications; first is the...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Journal of Anaesthesiology Clinical Pharmacology |
| Subjects: | |
| Online Access: | http://www.joacp.org/article.asp?issn=0970-9185;year=2021;volume=37;issue=1;spage=73;epage=78;aulast=Mazy |
| _version_ | 1819285098858545152 |
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| author | Alaa Mazy Mohamed Serry Mohamed Kassem |
| author_facet | Alaa Mazy Mohamed Serry Mohamed Kassem |
| author_sort | Alaa Mazy |
| collection | DOAJ |
| description | Background and Aims: Local anesthetic (LA) infiltration is one of the analgesic techniques employed during scoliosis correction surgery. However, its efficacy is controversial. In the present study for optimizing analgesia using the infiltration technique, we proposed two modifications; first is the preemptive use of high volume infiltration, second is applying three anatomical multilevel infiltrations involving the sensory, motor, and sympathetic innervations consecutively.
Material and Methods: This prospective study involved 48 patients randomized into two groups. After general anesthesia (GA), the infiltration group (I) received bupivacaine 0.5% 2 mg/kg, lidocaine 5 mg/kg, and epinephrine 5 mcg/mL of the total volume (100 mL per 10 cm of the wound length) as a preemptive infiltration at three levels; subcutaneous, intramuscular, and the deep neural paravertebral levels, timed before skin incision, muscular dissection, and instrumentation consecutively. The control group (C) received normal saline in the same manner. Data were compared by Mann-Whitney, Chi-square, and t-test as suitable.
Results: Intraoperatively, the LA infiltration reduced fentanyl, atracurium, isoflurane, nitroglycerine, and propofol consumption. Postoperatively, there was a 41% reduction in morphine consumption, longer time to the first analgesic request, lower VAS, early ambulation, and hospital discharge with high-patient satisfaction.
Conclusion: The preemptive, high-volume, multilevel infiltration provided a significant intra and postoperative analgesia in scoliosis surgery. |
| first_indexed | 2024-12-24T01:57:52Z |
| format | Article |
| id | doaj.art-d61b318f2f824f88ad7ddbfb2f6fa026 |
| institution | Directory Open Access Journal |
| issn | 0970-9185 |
| language | English |
| last_indexed | 2024-12-24T01:57:52Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Anaesthesiology Clinical Pharmacology |
| spelling | doaj.art-d61b318f2f824f88ad7ddbfb2f6fa0262022-12-21T17:21:32ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology0970-91852021-01-01371737810.4103/joacp.JOACP_338_17High-volume, multilevel local anesthetics–Epinephrine infiltration in kyphoscoliosis surgery: Intra and postoperative analgesiaAlaa MazyMohamed SerryMohamed KassemBackground and Aims: Local anesthetic (LA) infiltration is one of the analgesic techniques employed during scoliosis correction surgery. However, its efficacy is controversial. In the present study for optimizing analgesia using the infiltration technique, we proposed two modifications; first is the preemptive use of high volume infiltration, second is applying three anatomical multilevel infiltrations involving the sensory, motor, and sympathetic innervations consecutively. Material and Methods: This prospective study involved 48 patients randomized into two groups. After general anesthesia (GA), the infiltration group (I) received bupivacaine 0.5% 2 mg/kg, lidocaine 5 mg/kg, and epinephrine 5 mcg/mL of the total volume (100 mL per 10 cm of the wound length) as a preemptive infiltration at three levels; subcutaneous, intramuscular, and the deep neural paravertebral levels, timed before skin incision, muscular dissection, and instrumentation consecutively. The control group (C) received normal saline in the same manner. Data were compared by Mann-Whitney, Chi-square, and t-test as suitable. Results: Intraoperatively, the LA infiltration reduced fentanyl, atracurium, isoflurane, nitroglycerine, and propofol consumption. Postoperatively, there was a 41% reduction in morphine consumption, longer time to the first analgesic request, lower VAS, early ambulation, and hospital discharge with high-patient satisfaction. Conclusion: The preemptive, high-volume, multilevel infiltration provided a significant intra and postoperative analgesia in scoliosis surgery.http://www.joacp.org/article.asp?issn=0970-9185;year=2021;volume=37;issue=1;spage=73;epage=78;aulast=Mazyanalgesiaautonomicbupivacaineepinephrineinfiltrationpainparaspinal musclesscoliosisspinetumescent |
| spellingShingle | Alaa Mazy Mohamed Serry Mohamed Kassem High-volume, multilevel local anesthetics–Epinephrine infiltration in kyphoscoliosis surgery: Intra and postoperative analgesia Journal of Anaesthesiology Clinical Pharmacology analgesia autonomic bupivacaine epinephrine infiltration pain paraspinal muscles scoliosis spine tumescent |
| title | High-volume, multilevel local anesthetics–Epinephrine infiltration in kyphoscoliosis surgery: Intra and postoperative analgesia |
| title_full | High-volume, multilevel local anesthetics–Epinephrine infiltration in kyphoscoliosis surgery: Intra and postoperative analgesia |
| title_fullStr | High-volume, multilevel local anesthetics–Epinephrine infiltration in kyphoscoliosis surgery: Intra and postoperative analgesia |
| title_full_unstemmed | High-volume, multilevel local anesthetics–Epinephrine infiltration in kyphoscoliosis surgery: Intra and postoperative analgesia |
| title_short | High-volume, multilevel local anesthetics–Epinephrine infiltration in kyphoscoliosis surgery: Intra and postoperative analgesia |
| title_sort | high volume multilevel local anesthetics epinephrine infiltration in kyphoscoliosis surgery intra and postoperative analgesia |
| topic | analgesia autonomic bupivacaine epinephrine infiltration pain paraspinal muscles scoliosis spine tumescent |
| url | http://www.joacp.org/article.asp?issn=0970-9185;year=2021;volume=37;issue=1;spage=73;epage=78;aulast=Mazy |
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