PRE-INCISIONAL CAUDAL EPIDURAL BLOCKADE AND THE RELIEF OF PAIN AFTER LUMBAR SPINE OPERATIONS

We report the effect of pre-incisional caudal epidural injection of a mixture of 20 mi 0.25% bupivacaine and 0.1 mg buprenorphine performed under general anaesthesia for relieving wound pain after posterior int erbody fusion and laminotomy for spinal stenosis. Pain was compared in groups with and without blockade: 24 and 23 patients with fusion, and 30 and 28 with laminotomy respectively. rn the first 12 h after each operation, the group with blockade required additional analgesics less frequently and had a lower visual analogue scale score than those wit hout blockade. In, and after the second 24 h patients with hypotension of 10 mm Hg, or more, after the blockade required additional analgesi cs less frequently than those without blockade for both operations and had a lower visual analogue score than those without blockade for lam inotomy but not for fusion. This is a simple procedure for relieving w ound pain and in patients with hypotension caused by the block, the ef fect continued even after the analgesic action had disappeared.