Introduction Adequate postoperative pain management following lumbar spinal decompression surgery is important as it will lead to early mobilization, less complications and shorter hospital stay. Opioid consumption should be limited due to their frequently accompanied side effects and their addictive nature. During the final phase of lumbar decompression surgery, the epidural space becomes easily accessible. This might be an ideal moment for surgeons to administer an epidural bolus of analgesia, as a safe and effective method for post-operative pain relief. Methods This is a double blind randomized controlled trial comparing a single intraoperative bolus of epidural analgesia using bupivacaine 0.25% to placebo (NaCl 0,9%) and its effect on postoperative pain following lumbar spinal decompression surgery. The primary outcome was the difference in NRS pain between the intervention and placebo groups during the first 48h after surgery. It was hypothesized that the intervention group will have lower postoperative NRS pain scores. Results Both the intervention group and the placebo group consisted of 20 randomized patients (N=40). We observed statistically significant lower NRS pain scores in the intervention group in comparison with the control group, with a difference of -1.9 (±1.1). The average pain score was lower in the intervention group at all postoperative time-points. Opioid consumption, quality of life and satisfaction were similar between study groups. No study related complications occurred, and complications rate did not differ between study groups. Conclusion This randomized controlled trial shows that administrating a bolus of intraoperative epidural bupivacaine is a safe and effective method in reducing early postoperative pain following lumbar decompression surgery.

中文翻译：

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腰椎减压手术后单剂量硬膜外布比卡因与安慰剂对比：随机对照试验

简介 腰椎减压手术后充分的术后疼痛管理非常重要，因为这将导致早期活动、减少并发症和缩短住院时间。由于阿片类药物经常伴随副作用且具有成瘾性，因此应限制其消费。在腰椎减压手术的最后阶段，硬膜外腔变得容易进入。这可能是外科医生实施硬膜外推注镇痛的理想时机，作为术后疼痛缓解的安全有效方法。方法 这是一项双盲随机对照试验，比较使用 0.25% 布比卡因和安慰剂（0.9% 氯化钠）的单次术中硬膜外推注镇痛及其对腰椎减压术后术后疼痛的影响。主要结果是术后 48 小时内干预组和安慰剂组之间 NRS 疼痛的差异。假设干预组术后 NRS 疼痛评分较低。结果干预组和安慰剂组均由 20 名随机患者组成（N=40）。我们观察到，与对照组相比，干预组的 NRS 疼痛评分显着降低，差异为 -1.9 (±1.1)。干预组在所有术后时间点的平均疼痛评分较低。研究组之间的阿片类药物消耗量、生活质量和满意度相似。没有发生与研究相关的并发症，并且研究组之间的并发症发生率没有差异。