Intraoperative analgesic effect of intravertebral lidocaine injection during percutaneous kyphoplasty in the treatment of thoracolumbar compression fractures in elderly patients

Article type: Research Article

Authors: Yin, Jianshi^{a; 1} | Zhang, Yongzhao^{a; 1} | Zhao, Xiangmei^b | Yan, Han^a | Liu, Jun^a | Chang, Xiaohui^c | Wang, Junsheng^{a; *}

Affiliations: [a] Department of Orthopedics, The 967th Hospital of Joint Logistic Support Force of PLA, Dalian, Liaoning, China | [b] Department of Anesthesiology, The 967th Hospital of Joint Logistic Support Force of PLA, Dalian, Liaoning, China | [c] Department of Traditional Chinese Medicine, The 967th Hospital of Joint Logistic Support Force of PLA, Dalian, Liaoning, China

Correspondence: [*] Corresponding author: Junsheng Wang, Department of Orthopedics, The 967th Hospital of Joint Logistic Support Force of PLA, No. 80 Sheng Li Road, Xigang District, Dalian, Liaoning 116021, China. E-mail: wangjunshflj@outlook.com.

Note: [1] These authors contributed equally to this article.

Abstract: BACKGROUND: In recent years, percutaneous kyphoplasty (PKP) has been increasingly used in clinical settings. OBJECTIVE: In this study, we aimed to determine the analgesic effect of intravertebral lidocaine injections in PKP. METHODS: A total of 60 patients who were treated with PKP were enrolled in this study. Lidocaine hydrochloride was chosen as the medication for the experimental group. Patients were randomly assigned into three groups using a double-blind study design: In group A (20 cases), no drugs were injected into the vertebral body during surgery; group B (20 cases) received intravertebral injection of normal saline; and in group C (20 cases), lidocaine hydrochloride was administered into the vertebral body during surgery. The age of patients, operation time, balloon dilatation pressure, balloon dilatation volume, and amount of bone cement injected were compared across the three groups. A pain visual analog scale (VAS) was used to assess pain suffered by the patients before, during, and 24 hours after the surgery. RESULTS: Age, operation time, balloon dilatation pressure, balloon dilatation volume, and amount of bone cement injected did not differ significantly among the three groups (P> 0.05). The differences in VAS scores 24 hours before and after surgery were not statistically significant (P> 0.05). Group C had lower intraoperative VAS scores than groups A and B, and the difference was statistically significant (P< 0.01). There was no statistically significant difference between group A and group B (P> 0.05). CONCLUSION: Intravertebral injections of lidocaine during PKP can successfully reduce intraoperative pain.

Keywords: Compression fracture, intravertebral, lidocaine, PKP, the elderly

DOI: 10.3233/BMR-220174

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 5, pp. 1095-1100, 2023