Preliminary Study on Effectiveness of Dexamethasone-Soaked Gelatin Sponges for Reducing Pain after Lumbar Microdiscectomy: A Randomized Controlled Trial.

Shin, Dong Ah; Gong, Tae Sik; Shin, Dong Gyu; Kwon, Chang Young; Kim, Hyoung Ihl

Original Article

Journal of Korean Neurosurgical Society 2006;39(1): 11-15.

Dong Ah Shin, Tae Sik Gong, Dong Gyu Shin, Chang Young Kwon, Hyoung Ihl Kim

Department of Neurosurgery, Presbyterian Medical Center, Jeonju, Korea. cistern@hanmail.net

ABSTRACT

OBJECTIVE
A prospective, randomized, controlled clinical study is performed to verify the effectiveness of epidural dexamethasone-soaked gelatin sponges to reduce postoperative pain following lumbar microdiscectomy.
METHODS
Twenty-three patients (10 men and 13 women) undergoing lumbar microdiscectomy were included. Five pieces of gelatin sponge measuring 1 x 1 cm (Gelfoam; Pharmacia & Upjohn, Kalamazoo, MI, USA), soaked with either 5mg dexamethasone or an equal amount (2 mL) of saline, were left on the decompressed nerve root after unilateral hemilaminectomy, flavectomy and discectomy.
RESULTS
Subjective visual analog scale(VAS) scores of leg pain in the dexamethasone group on the first, third and fifth postoperative days (2.5, 2.5, 1.7, respectively) were significantly lower than in the control group (5.0, 4.8, 3.6) ( P<0.05). No side effects related to the dexamethasone-soaked gelatin sponges were observed.
CONCLUSION
The intraoperative application of dexamethasone-soaked gelatin sponges during lumbar microdiscectomy can provide effective postoperative analgesia without complications.

Key Words: Dexamethasone; Gelatin sponges; Microdiscectomy; Randomized controlled trial