Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 6;22(1):660.
doi: 10.1186/s12891-021-04541-w.

Efficacy of gelatin sponge impregnated with ropivacaine on postoperative pain after transforaminal lumbar interbody fusion: a comparative study

Shanxi Wang  1 , Bo Wang  1 , Xiaojun Yu  1 , Tian Ma  1 , Mubotu C Ntambale  1 , Jiyuan Yan  1 , Qing Ding  1 , Ruizhuo Zhang  1 , Hua Wu  2 , Chaoxu Liu  3
Affiliations

Efficacy of gelatin sponge impregnated with ropivacaine on postoperative pain after transforaminal lumbar interbody fusion: a comparative study

Shanxi Wang et al. BMC Musculoskelet Disord. .

Abstract

Background: The purpose of this study was to investigate the efficacy of gelatin sponge impregnated with ropivacaine on postoperative pain after transforaminal lumbar interbody fusion (TLIF) in patients with lumbar degenerative diseases.

Methods: We retrospectively reviewed patients who underwent TLIF in our department between August 2018 and January 2020. Patients were divided to ropivacaine group and saline group. A ropivacaine group whom received gelatin sponge impregnated with ropivacaine during operation, and a saline group whom were intraoperatively administered by gelatin sponge impregnated with saline. The two groups were compared in reference to postoperative hospital stay, postoperative complications and visual analog scale (VAS) scores. The consumption of postoperative diclofenac sodium suppository use was also recorded. The Oswestry Disability Index (ODI) scores and Japanese Orthopedic Association (JOA) scores were used for functional evaluation at 1 year postoperatively.

Result: A total of 127 patients were evaluated in this retrospective study. The mean postoperative hospital stay in the ropivacaine group was significantly lower than saline group. The VAS score was significantly lower in patients receiving gelatin sponge impregnated with ropivacaine as compared with patients in saline group on postoperative day 1, 2, 3 and 4. The number of patients who need the administration of diclofenac sodium suppository and the mean consumption of postoperative diclofenac sodium suppository was significantly lower in the ropivacaine group as compared with saline group.

Conclusion: The application of gelatin sponge impregnated with ropivacaine around the nerve root in patients undergoing TLIF can effectively control the postoperative pain and reduce postoperative hospital stay.

Keywords: Gelatin sponge; Lumbar degenerative diseases; Postoperative pain; Ropivacaine; Transforaminal lumbar interbody fusion.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Operation steps of gelatin sponge impregnated with ropivacaine. a The gelatin sponge was immersed in a syringe filled with ropivacaine, and the gas in the syringe was evacuated. b Plug the outlet of the syringe with a finger while pulling back the piston repeatedly with the other hand to create a negative pressure in the syringe. c The residual gas in the gelatin sponge was sucked out by negative pressure and formed bubbles in the syringe. d-e Remove the bubbles from the syringe, the volume of ropivacaine in the syringe was significantly decreased compared to before, which proved that the gelatin sponge further absorbed ropivacaine. f The location of the intraoperatively gelatin sponge
See this image and copyright information in PMC

References

    1. Rosenberg WS, Mummaneni PV. Transforaminal lumbar interbody fusion: technique, complications, and early results. Neurosurgery. 2001;48(3):574–575. doi: 10.1097/00006123-200103000-00022. - DOI - PubMed
    1. Ghabach MB, Mhanna NE, Abou AEM, et al. Comparison of effects of hemostatic gelatin sponge impregnated with Ropivacaine versus Normal saline applied on the transverse process of the operated vertebrae on postoperative pain in patients undergoing spinal instrumentation surgery: a randomized clinical trial. World Neurosurg. 2019;128:e1126–e1130. doi: 10.1016/j.wneu.2019.05.101. - DOI - PubMed
    1. Aljabi Y, Aljabi Y. Effect of epidural methylprednisolone on post-operative pain and length of hospital stay in patients undergoing lumbar microdiscectomy. Surg J Royal Colleges Surg Edinburgh Ireland. 2015;13(5):245–249. doi: 10.1016/j.surge.2014.03.012. - DOI - PubMed
    1. Markham A, Faulds D. Ropivacaine. Drugs. 1996;52(3):429–449. doi: 10.2165/00003495-199652030-00012. - DOI - PubMed
    1. Axelsson K, Johanzon E, Essving P, Weckstrom J, Ekback G. Postoperative extradural analgesia with morphine and ropivacaine. A double-blind comparison between placebo and ropivacaine 10 mg/h or 16 mg/h. Acta Anaesth Scand. 2005;49(8):1191–1199. doi: 10.1111/j.1399-6576.2005.00715.x. - DOI - PubMed

LinkOut - more resources