Preemptive Analgesia for Postlaminectomy

To relieve post laminectomy pain, we have tried intraoperative perineural injection of lidocaine right after the exposure in expecting that this would be preemptive analgesia by blocking the nerve transmission so that postoperative pain starts later and lighter.

A randomized double-blind 40 patients aged 18-50 of ASA I and II undergoing laminectomy were included in the study. All the patients were followed for their heart rate, arterial pressure , respiratory rate, oxygen saturation, end tidal CO2 and postoperative VAS scores.

All the patients were premedicated with midazolam 0.1 mg/kg intramuscularly 40 minutes prior to surgery. The induction was made 2 mg/kg propofol, 1 ug/kg remifentanyl, 0.5mg/kg rocuronium. After the orotracheal intubation anesthesia was maintained with isoflurane (%0.5-2.0) and 0.1 mg/kg rocuronium.Just before the exposure of dorsal root, 0.5 cc %2 lidocaine was injected on the dorsal root.The patients postoperative analgesic period, VAS scores and additional analgesic need was recorded. For the postoperative analgesia tramadol 1 mg/kg tramadol was used.

• Drug: Lidocaine, perineural injection, intraoperatively
  0.5 cc lidocaine, one single injection over the dorsal root.
  Other Name: lidocaine
• Drug: Lidocaine
  0.5 cc %2 lidocaine,single injection

• Placebo Comparator: A01L
  Interventions:

  • Drug: Lidocaine, perineural injection, intraoperatively
  • Drug: Lidocaine
• No Intervention: B01C

Inclusion Criteria:

• laminectomy
• 18-50 age
• ASA 1-2
• both sex

Exclusion Criteria:

• under 18 or older than 50
• any disease other than back pain\
• ASA 3-4