The efficacy of combined bupivacine/fentanyl continuous wound catheter infusion after lumbar fixation surgery: a randomized, double-blind, controlled study

Background Lumbar fixation surgery is associated with moderate to severe postoperative pain.Methods A total of 68 patients of both sexes admitted for elective posterior stabilization for lumbar instability (ASA status I–II) were randomly allocated to receive either a 0.25% bupivacaine/fentanyl mixture (group BF, n = 34) or placebo in the form of normal saline (group P, n = 34) by a continuous infusion through a catheter placed subcutaneously at the end of surgery. The catheter was removed after 48 h postoperatively. Pain was assessed every 4 h after surgery using a visual analog scale. Opioid consumption, opioid-related side effects (postoperative nausea and vomiting, respiratory depression, or pruritus), wound-related complications (poor healing or infection), and patientsatisfaction scores were compared in both groups. Results Bupivacaine/fentanyl wound infusion resulted in better analgesia and a significant decrease in opioid consumption. With respect to opioid-related and wound-related complications, there were no statistically significant differences between the two groups. The overall patient satisfaction was significantly higher in the BF group when compared with group P. Conclusion It was concluded that bupivacaine/fentanyl wound instillation improves pain control, decreases opioid requirements, and increases overall patient satisfaction.