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Study of Effect of Nerve Root Blockade Before the Onset of Noxious Stimuli on Postoperative Pain Control After Thoracolumbar Spinal Surgery

Mahendra M , Rajesh Kumar Singh1 , Mahendra M2 , Ananthakishan3 , Jay Prakash4 , J Prashanth Prabhu5

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International Journal of Neurology and Neurosurgery 11(4):p 277-282, October-December 2019. | DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.11419.2

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Rajesh Kumar Singh, Mahendra M, Ananthakishan, et al. Study of Effect of Nerve Root Blockade Before the Onset of Noxious Stimuli on Postoperative Pain Control After Thoracolumbar Spinal Surgery. Int J Neurol Neurosurg. 2019;11(4):277-282.

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Abstract

Context: Patient recovery improves with effective postoperative pain control after spinal surgeries. Pain control is not equivocal by different techniques in spite of all the surgical and non-surgical advances made till date. Aims: This study was aimed at proving the hypothesis that neural root blockade before the onset of noxious stimuli could inhibit or reduce the production of pain. Settings and Design: Prospective, cohort, and single-blinded clinical study from 2016 to 2018 of 150 cases. Methods and Material: One hundred and fifty patients undergoing spinal surgeries were included in the study. In 75 of the patients (Group 2), 0.5 ml lidocaine 2% was applied onto the neural root immediately after the exposure and in 75 patients in the control group (Group 1) no topical application was done. All patients were monitored regarding pain determination using Visual Analogue Scale, and the exact time of analgesic requirement during the first postoperative day was recorded. Statistical analysis used: The Statistical software namely SPSS 18.0, and R environment ver.3.2.2 were used for the analysis of the data and Microsoft word and Excel have been used to generate graphs, tables, etc. Results: Topical perineural lidocaine application extended the early postoperative analgesic duration; although, the pain was not completely suppressed, the lidocaine application helped to manage the postoperative pain more effectively. The patients (Group 2) who received lidocaine application intraoperatively onto the neural root had a statistically significant longer duration before analgesia requested (p < 0.001) and also required significantly less analgesic when compared with the control group (p < 0.001). Conclusions: Acute postoperative pain in spinal surgery remains a major concern. The study suggests that lidocaine application onto the dorsal neural sheath immediately before retraction of the root may extend the time before analgesia requested and the total analgesic drug consumption.

Keywords: Nerve root blockade; Noxious stimuli; Pain; Spine surgery.

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Rajesh Kumar Singh, Mahendra M, Ananthakishan, et al. Study of Effect of Nerve Root Blockade Before the Onset of Noxious Stimuli on Postoperative Pain Control After Thoracolumbar Spinal Surgery. Int J Neurol Neurosurg. 2019;11(4):277-282.

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DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.11419.2

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