Thoracic Epidural Analgesia for Lumbosacral Spine Surgery: A Randomized, Case-Control Study

Abstract

Background: Traditional analgesics such as diclofenac and celecoxib have long been used in lumbosacral spine surgeries. Recently, preemptive single-shot caudal analgesia has been investigated by some workers with favorable results. We hypothesized that the thoracic route would not only allow preemptive but also postoperative analgesia through catheter insertion. Aim: We aimed at studying the feasibility and efficacy of thoracic epidural analgesia (TEA) in lumbosacral spine surgeries. Settings and Design: This was a prospective, randomized, controlled study that comprised 60 American Society of Anesthesiologist (ASA) Physical Status I and II patients posted for lumbosacral spine surgeries. Materials and Methods: Sixty ASA I and II patients were randomly divided into two groups: Group T – TEA was given using 0.2% ropivacaine 10 mL preemptive and postoperatively. Group C patients were given analgesia with intramuscular diclofenac 75 mg. Hemodynamic parameters, postoperative Visual Analog Scale scores, and neurological complications were noted. Statistical Analysis: Student s independent t-test for comparing the continuous variables and Chi-square test for the categorical variables. Kruskal–Wallis test was used for postoperative pain data. Results: Duration and quality of analgesia were superior in Group T. There were more hemodynamic alterations in Group C but no neurological complication in any patient. Conclusion: TEA proves to be an effective analgesic technique for lumbosacral spine surgeries.