Background and aims
Narcotics are commonly used in controlling of the postoperative pain. But few studies are available about direct narcotic spillage into surgical field. The aim of this study was to check the efficacy of this method for analgesia in postoperative lumbar microdiscectomy.
Methods
In a randomized clinical trial, numbers of 100 patients were included into two equal groups due to low back radicular pain and, underwent microdiscectomy. Study group received direct morphine (2mg/5mL) spillage and control group received normal saline (5mL) spillage as a placebo. The main outcome to be compared between trial and placebo groups were: Patient comfort rate in recovery room and ward, amount of analgesics used, postoperative ambulation time, post operative hospitalization days.
Results
Mean Systolic blood pressure increment was lower in morphine group.
The restlessness and agitation during recovery in study group was lower than control group. Only %6 of patients in study group compared to %98 in placebo group had either moderate or severe pain, six hours after operation.
Mean morphine dose used for study group was 10.75 mg compared to 21.4 mg among control group patients (p<0.0001). Mean ambulation time was 2 days among study group patients compared to 2.6 days in control group. Mean hospitalization length was 4.7 and 7 days in study and control group respectively.
Conclusion
Using epidural morphine spillage (EMS) during Lumbar microdiscectomy results in better control of postoperative pain, early ambulation of patients and decreased hospitalization length.