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British Journal of Anaesthesia, 2000, Vol. 84, No. 6 731-734
© 2000 Oxford University Press

Clinical Investigation

Does wound irrigation with triamcinolone reduce pain after surgery to the lumbar spine?

L. H. Pobereskin1 and J. R. Sneyd2

1 Department of Neurosurgery, Derriford Hospital, Plymouth PL6 8DH, UK
2 Department of Anaesthesia, Derriford Hospital, Plymouth PL6 8DH, UK

Abstract

This prospective, randomized study compared postoperative pain scores, morphine consumption and length of stay in 95 adults who underwent elective lumbar spine surgery via a posterior incision. Immediately prior to closure the wound was irrigated with triamcinolone 40, 20 or 0 mg. Visual analogue scale pain scores at 24 h after surgery were median 12 (interquartile range 3–24), 15 (6–34) and 33 (20–59) mm for patients receiving triamcinolone 40, 20 mg or no steroid, respectively (P<0.0005, Kruskal–Wallis test). Total morphine usage after 24 h was 26 (21–39), 27 (17–43) and 43 (27–73) mg for the same groups (P<0.001, Kruskal–Wallis test). The proportion of patients discharged from hospital on the first day after surgery was 83.9, 77.4 and 54.8% for patients receiving triamcinolone 40, 20 mg and no steroid, respectively (P<0.028, chi-squared test). Extra-dural triamcinolone reduces pain after lumbar spine surgery and reduces time to discharge from hospital.


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