Epidural Gel-Foam Impregnated with Bupivacaine versus Paravertebral Intramuscular Bupivacaine for Postoperative Analgesia in Lumbar Spine Surgery: A Comparative Clinical Trial

Objectives: This study aimed to compare the effect of epidural gel foam impregnated with bupivacaine and intramuscular paravertebral bupivacaine on analgesia after lumbar spine surgeries.Methods: In this single-blind clinical trial, ۶۰ patients aged ۱۸–۶۵ years who underwent lumbar spine surgery under general anesthesia were randomly assigned to two groups. In the first group, a ۱ × ۵ cm strip of gel foam impregnated with ۷۰ mg of ۰.۵% bupivacaine was placed in the epidural space. In contrast, in the second group, ۷۰ mg of ۰.۵% bupivacaine was injected paravertebrally into the muscle. Pain scores based on the Visual Analogue Scale (VAS), analgesic prescriptions, time to first analgesic request, and total dosage during recovery and at ۶, ۱۲, and ۲۴ hours postoperatively were recorded and compared between the groups.Results: No significant difference in average pain scores at different time points (recovery, ۶, and ۱۲ hours) was observed between the two groups (P > ۰.۰۵). However, at ۲۴ hours postoperatively, a significant difference was found between the groups, with the VAS score in the bupivacaine-impregnated epidural gel foam group being significantly lower than that in the paravertebral intramuscular bupivacaine group (P = ۰.۰۴).Conclusion: Bupivacaine-impregnated epidural gel foam and paravertebral intramuscular bupivacaine provide similar analgesia during recovery and at ۶ and ۱۲ hours following spinal surgery. However, at ۲۴ hours, the analgesia in the bupivacaine-impregnated epidural gel foam group is superior to that in the paravertebral intramuscular bupivacaine group.        Level of evidence: I

کلیدواژه ها:

Analgesia ، bupivacaine-impregnated epidural gel foam ، lumbar spine surgeries ، paravertebral intramuscular bupivacaine