No Improvement in Dysphasia Outcomes with Bupivacaine HCl in Anterior Cervical Discectomy & Fusion .
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Local Retropharyngeal Space Anesthetic for Dysphagia Reduction after Anterior Cervical Discectomy and Fusion Surgery: A Single-Center, Prospective, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial
World Neurosurg. 2021 Feb;146: e1377-e1383.One hundred and twenty patients undergoing 1- or 2-level anterior cervical discectomy and fusion (ACDF) surgery for treatment of cervical degenerative disc disease with disc herniation, radiculopathy, and/or myelopathy symptoms were randomized to receive a 0.5% bupivacaine hydrochloride solution or 0.9% NaCl normal saline solution which was injected into the retropharyngeal space. Primary outcomes of interest included the following: occurrence of dysphagia symptoms, duration of dysphasia symptoms, and reduction in dysphagia symptoms. Dysphasia symptoms were evaluated using the Swallowing-Quality of Life (SWAL-QOL) survey. Secondary outcomes of interest included incidence of patients referred to a specialist and incidence of patients who underwent speech therapy. Furthermore, pain in the neck and arm were measured using the Visual Analogue Scale (VAS). Results of this study revealed no statistical significant difference between the two groups in all outcomes (p>0.05 for all). The incidence of dysphasia symptoms was 74% and 77% in the bupivacaine and placebo group, respectively. 13.8% of patients were referred to a specialist and 11.3% of patients underwent speech therapy for dysphasia symptoms.
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