Epidural Morphine and Bupivacaine For Post-Op Analgesia After Transforaminal Lumbar Interbody Fusion .
A Randomised Controlled Study on Epidural Morphine and Bupivacaine for Post-Operative Analgesia After Transforaminal Lumbar Interbody Fusion.
Global Spine J . 2023 Sep;13(7):1926-1931.One hundred patients undergoing transforaminal lumbar interbody fusion (TLIF) for various lumbar pathologies were randomized to receive either an intraoperative epidural instillation of morphine 5 mg with 2 mL of 0.25% bupivacaine and additional 6 mL bupivacaine infiltration into deep fascia (n=50), or no such instillation (n=50). The primary outcome was post-operative pain, assessed using VAS and NRS scores. Secondary outcomes included time to ambulation, need for breakthrough analgesia, PONV score, Ramsay sedation score, and complications. Outcomes were assessed up to 96 hours postoperatively. Overall, the results of the study revealed significantly lower pain scores in the study group at all time points during the first 48 hours and earlier ambulation. The findings suggest that this simple, safe intervention enhances post-operative recovery and pain control.
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