Use of an Epidural Steroid Sponge for Postoperative Pain Control in Lumbar Discectomy

Introduction: There are many methods to control postoperative pain after lumbar discectomy, including opioid analgesics, epidural catheters, and epidural steroid Gelfoam sponges.
Aims/

Objectives: This study was conducted to evaluate the effects of using an epidural steroid sponge for postoperative pain control in lumbar discectomy.

Methods: A total of 72 patients who underwent surgery between March 2011 and February 2014 were enrolled. Their average age was 54 years (range, 24-82 years). In group A (35 patients), Gelfoam was inserted after being soaked with a solution of 2% lidocaine (400 mg/20 mL; 1 vial) and dexamethasone (5 mg/mL; 1 ampoule). In group B (37 patients), it was inserted after soaking with normal saline. Postoperative pain was assessed by visual analogue scale (VAS) scores. Pain above 5 points was controlled by a narcotic analgesic agent, and the duration and number of postoperative interventions, the period of time before walking after the operation, and the period until the date of discharge after surgery were assessed and compared. The Mann-Whitney U test was used as a nonparametric method. P-values less than 0.05 were considered to indicate statistical significance.

Results: In group A, 15 patients did not require analgesics on the day of surgery. In 20 patients, no analgesics were needed on postoperative day (POD) 1. In group B, 8 patients on the day of surgery and 13 patients on POD 1 did not require analgesics. In group A, 26 patients were able to walk on the day of surgery, and all patients were able to walk on POD 1. In group B, 19 patients was able to walk on the day of surgery and all patients were able to walk on POD 1. The mean number of hospital days before discharge was 6.3 in group A and 8.2 in group B.

Conclusions: By continuously releasing low doses of steroids into the epidural space, this technique provided satisfactory results for postoperative pain control.