J Korean Soc Spine Surg.  2019 Jun;26(2):50-55. 10.4184/jkss.2019.26.2.50.

Use of an Epidural Steroid Sponge for Postoperative Pain Control in Lumbar Discectomy

• Kim TK
• Yu HK
• Oh SK
• Kim YM
• Shim DM

• KMID: 2451313
• DOI: http://doi.org/10.4184/jkss.2019.26.2.50

Abstract

STUDY DESIGN: Retrospective study.
OBJECTIVES
This study was conducted to evaluate the effects of using an epidural steroid sponge for postoperative pain control in lumbar discectomy. SUMMARY OF LITERATURE REVIEW: There are many methods to control postoperative pain after lumbar discectomy, including opioid analgesics, epidural catheters, and epidural steroid Gelfoam sponges.
MATERIALS AND METHODS
A total of 72 patients who underwent surgery between March 2011 and February 2014 were enrolled. Their average age was 54 years (range, 24-82 years). In group A (35 patients), Gelfoam was inserted after being soaked with a solution of 2% lidocaine (400 mg/20 mL; 1 vial) and dexamethasone (5 mg/mL; 1 ampoule). In group B (37 patients), it was inserted after soaking with normal saline. Postoperative pain was assessed by visual analogue scale (VAS) scores. Pain above 5 points was controlled by a narcotic analgesic agent, and the duration and number of postoperative interventions, the period of time before walking after the operation, and the period until the date of discharge after surgery were assessed and compared. The Mann-Whitney U test was used as a nonparametric method. P-values less than 0.05 were considered to indicate statistical significance.
RESULTS
In group A, 15 patients did not require analgesics on the day of surgery. In 20 patients, no analgesics were needed on postoperative day (POD) 1. In group B, 8 patients on the day of surgery and 13 patients on POD 1 did not require analgesics. In group A, 26 patients were able to walk on the day of surgery, and all patients were able to walk on POD 1. In group B, 19 patients was able to walk on the day of surgery and all patients were able to walk on POD 1. The mean number of hospital days before discharge was 6.3 in group A and 8.2 in group B.
CONCLUSIONS
By continuously releasing low doses of steroids into the epidural space, this technique provided satisfactory results for postoperative pain control.

Keyword

Lumbar disc herniation; Gelfoam sponge; Lumbar discectomy; Epidural analgesia

MeSH Terms

Analgesia, Epidural
Analgesics
Analgesics, Opioid
Catheters
Dexamethasone
Diskectomy*
Epidural Space
Gelatin Sponge, Absorbable
Humans
Lidocaine
Methods
Pain, Postoperative*
Porifera*
Retrospective Studies
Steroids
Walking
Analgesics
Analgesics, Opioid
Dexamethasone
Lidocaine
Steroids

Figure

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  Fig. 1. Preoperative and postoperative visual analogue scale (VAS) scores in the 2 groups.

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