The Influence of Epidural Steroids on Postoperative Pain and Hospital Stay in Patients Having a Single-Level Lumbar Discectomy | [Pakistan Journal of Neurological Surgery • 2022]

Author(s):

1. Shah Khalid: Departments of,,Neurosurgery,Ayub Teaching Hospital, Abbottabad , Pakistan

2. Abdul Aziz khan: Departments of,,Neurosurgery,Ayub Teaching Hospital, Abbottabad , Pakistan

3. Faiza Khalid: Obstetric & Gynecology Ayub Teaching Hospital, Abbottabad , Pakistan

4. Shahbaz Ali Khan: Departments of,,Neurosurgery Ayub Teaching Hospital, Abbottabad , Pakistan

5. Abdul Majid: Departments of,,General Medicine, Ayub Teaching Hospital,Abbottabad -,Pakistan

6. Deen Muhammad: Departments of,,Neurosurgery,Ayub Teaching Hospital, Abbottabad , Pakistan

Abstract:

Background/Objective: Poorly managed postoperative pain after lumbar disc surgery is linked to a slower recovery, a longer hospital stay, and a higher usage of analgesics. Intraoperative epidural steroids have been used to reduce post-operative discomfort after lumbar discectomy. In this study, we looked at how intraoperative epidural steroids affected postoperative pain and stay duration in patients with unilateral singlelevel lumbar discectomy. Material & Methods: A randomized control trial was conducted at Ayub Teaching Hospital Abbottabad. Group A (n = 30) was given intraoperative epidural methylprednisolone, while group B (n = 30) was given normal saline only. The outcome was measured between the two groups in terms of postoperative pain (visual analog scale), time of mobilization, length of hospital stay, and duration to return to work. Results: At discharge, the VAS score in group A was 0.40 compared to 2.4 in group B (p = 0.000). At 2 weeks follow-up, the mean VAS score was 1.10 in group A in contrast to 1.4 in group B (p = 0.001). Patients who received local epidural methylprednisolone were mobilized after an average of 1 day, stayed for an average of 1.16 days, and returned to work following 18.2 days, whereas patients in the control group were mobilized after an average of 1.2 days, stayed for an average of 1.86 days and returned to work following 25.9 days. An incidental Dural tear occurs in 2 cases. Conclusion: Intra-operative epidural steroid is beneficial in reducing post-operative pain, hospital stay, and time to return to work. It allows early mobilization with enhanced recovery and few complications.

Page(s): 388-394

DOI: 10.36552/pjns.v26i3.769

Published: Journal: Pakistan Journal of Neurological Surgery, Volume: 26, Issue: 3, Year: 2022

Keywords:

Lumbar discectomy , postoperative pain , Epidural Steroids , Visual Analog Scale VAS

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