Analgesic Effect of Wound Infiltration with Morphine versus Dexketoprofen, Tramadol, and Bupivacaine in Lumbar Disc Surgeries

Background and Purpose: Wound infiltration using local anesthetics, anti-inflammatory drugs and opioids can significantly improve postoperative analgesia. The purpose of this clinical study was to determine the most effective method of wound infiltration among morphine, tramadol, dexketoprofen and bupivacaine for postoperative analgesia in patients undergoing lumbar discectomy. Methods: One hundred patients undergone elective lumbar discectomy operations were included. Patients were randomly allocated to one of five groups: wound infiltration with 10 mg morphine (group M), with 100 mg tramadol (group T), with 50 mg dexketoprofen (group D), with 100 mg bupivacaine (group B) or control group (group C). Pain scores using visual analog scale (VAS) at 15th min, 1st, 6th, 12th, and 24th hours postoperatively and 24-h analgesic requirements were recorded. Results: No differences were determined between the four groups by means of demographic and clinical characteristics. In terms of patient satisfaction, Group M was significantly superior to groups D and B, respectively (p<0.05 for all). Post-hoc analyses revealed that the 15-min VAS score was significantly lower in Group M than in Group D; the 1-h VAS score was significantly lower than in groups T and A; the 6-h VAS score was significantly lower than in groups T, A and B, and the 24-h VAS score was significantly lower than in groups D and B, respectively (p<0.05). Tramadol consumption in the postoperative period was significantly lower in Group M than in Group B (p=0.004). There was significant reduction in other four groups according to Group C about the postoperative analgesic consumption. Conclusion: The incision infiltration using morphine is superior when compared to tramadol, dexketoprofen, and bupivacaine for controlling postoperative pain in lumbar discectomies