Efficacy and safety of ropivacaine combined with betamethasone in the treatment of early neurogenicin pain after lumbar UBE surgery
10.3760/cma.j.cn115396-20240823-00262
- VernacularTitle:罗哌卡因联合倍他米松治疗腰椎UBE术后早期神经根性疼痛的有效性与安全性
- Author:
Jing AN
1
;
Guoyu NI
;
Jinjun LI
;
Qi FEI
;
Hai MENG
Author Information
1. 首都医科大学附属北京友谊医院骨科，北京 100050
- Keywords:
Lumbar vertebrae;
Betamethasone;
Pain, postoperative;
Lumbar degenerative disease;
Ropivacaine
- From:
International Journal of Surgery
2024;51(12):834-839
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and safety of ropivacaine combined with betamethasone in the treatment of early neurogenicin pain after unilateral biportal endoscopy (UBE) surgery.Methods:A retrospective case-control study was conducted on a total of 179 patients with lumbar degenerative diseases who underwent unilateral biportal endoscopic spine surgery in the orthopedic department of Beijing Friendship Hospital Affiliated to Capital Medical University from March 2020 to January 2024. The observation group ( n=82) and the control group ( n=97) were divided according to whether or not drugs were injected locally into the nerve root during the operation; the injected drug in the observation group was a mixture of ropivacaine and betamethasone, and no drugs were injected locally in the control group.General information such as gender, age, and body mass index of patients in both groups were recorded. Additionally, VAS scores for lower extremity pain at various time points after surgery (12 h, 24 h, 48 h post-operation), clinical efficacy, and related complications were documented. Peripheral blood leukocytes and fasting blood glucose levels were monitored during the perioperative period.Normally distributed measures were expressed as mean±standard deviation( ± s), and t-test was used for comparison between groups, while non-normally distributed measures were expressed as M( Q1, Q3), and rank sum test was used for comparison between groups. The chi-square test was used to compare the count data between groups. Results:All patients underwent surgical procedures without any complications. In comparison to their preoperative condition, patients were monitored at various intervals post-surgery, revealing a notable decline in VAS scores for lower extremity pain in both patient groups ( P<0.05). The VAS scores for lower limb pain at 12 and 24 hours after surgery in the observation group were(2.57±1.19)scores and(1.83±0.86)scores, respectively, compared with (3.43±1.68) scores and (3.14±1.49) scores in the control group, which were significantly lower in the observation group compared with the control group, and the difference was statistically significant in the comparison between the two groups ( P<0.05). Nevertheless, by 48 hours after surgery, the VAS scores for lower extremity pain were comparable between the two groups, showing no significant variation ( P>0.05). Following three months after surgery, we conducted a thorough assessment of surgical outcomes utilizing the Fischgrund evaluation criteria. The findings indicated that the observation group achieved a commendable rate of 90.2%, whereas the control group attained a good rate of 88.7%. Despite the disparity between the two groups, further statistical examination disclosed that this difference lacked statistical significance ( P>0.05). Additionally, there were no noteworthy statistical disparities in the occurrence of complications, including nerve damage, dural tears, or epidural hematomas, between the two groups ( P>0.05). The peripheral blood leukocyte count in the observation group was (10.58±2.68)×10 9/L and fasting blood glucose was (9.51±1.93) mmol/L, compared with (6.97±2.19)×10 9/L and (6.87±1.76) mmol/L in the preoperative period and (6.89±2.24)×10 9/L and (6.68±1.84) mmol/L in the control group, respectively. The observation group was significantly higher compared to the preoperative and control groups, and the difference was statistically significant ( P<0.05). Conclusion:Local injection of a mixture of ropivacaine and betamethasone during lumbar UBE surgery is clinically effective in relieving neurogenic pain in the early postoperative period, and did not increase perioperative complications, but had some effect on peripheral blood leukocyte counts and blood glucose.
