Local wound anesthesia in spine surgery-a randomized, double-blind, controlled trial.

Study Summary

125 adults undergoing elective primary or revision lumbar spine surgery were randomized to receive intraoperative wound infiltration with 0.75% ropivacaine, 0.5% levobupivacaine combined with tramadol, or 0.9% saline placebo. The primary outcome of interest was postoperative back pain, measured using the visual analogue scale (VAS) at 2, 4, 8, and 12 hours after surgery. Secondary outcomes included opioid consumption, length of hospital stay, duration of sick leave, functional disability, and adverse events. Outcomes were assessed up to 6 weeks postoperatively. Overall, the results revealed no significant differences in postoperative pain scores or opioid consumption between the treatment groups. Although ropivacaine was associated with a shorter duration of sick leave compared with placebo, hospital stay, functional recovery, and adverse events were comparable. These findings suggested that local wound infiltration with ropivacaine or levobupivacaine/tramadol was safe but did not provide meaningful additional analgesic benefits following lumbar spine surgery.