Abstract
Introduction
This study was performed to investigate the efficacy of steroid and local anaesthesia (LA) in reducing post-operative pain in lumbar discectomy.
Materials and methods
The study was ethically approved. Patients undergoing primary single level lumbar discectomy were randomised by a closed envelope system into 4 groups, which were (Group 1) 10mg of adcortyl in 1ml and 1ml of 0.5% marcaine, (Group 2) 10mg of adcortyl and 1ml of normal saline, (Group 3) 1ml of 0.5% marcaine and 1ml of normal saline and (Group 4) 2mls of normal saline as control. Combinations of the above were applied topically over the nerve root prior to closure. Pre-operative, day 1 and eight weeks post-operative pain scores were recorded. 24 hours post-operative opiate analgesia requirements and duration of inpatient stay were recorded. Data were analysed using student t-test for statistical significance.
Results
100 patients were recruited into the study. There were no significant differences seen in the mean age, gender and the mean pre-operative pain score between all groups. Mean day one pain score in groups 1,2,3 and 4 was 0.9,2.5, 2.1 and 3.3 respectively. Mean 24 hours post-operative opiate requirement was 32.4mg, 54mg, 48.8mg and 56.4mg respectively. Mean inpatient stay was 2.2 days, 3.9 days, 4.62 days and 3.63 days respectively. A significant different (p<0.05) was noted in day one post-operative mean pain score, mean 24 opiate requirement and mean inpatient stay in the corticosteroid and LA group. At 8 weeks post-operatively, no significant differences were seen in the pain score in all groups.
Conclusions
Significant early post-operative pain reduction was achieved in the steroid and local anaesthesia group compared with other groups (p<0.05). A significant reduction in the 24-post operative analgesia requirement (p<0.05) and in inpatient stay (p<0.05) was also observed.
