Comparison of the Efficacy of Peri-Operative Use of Bupivacaine with Corticosteroids Versus Bupivacaine Alone in Lumbar Disc Disease Surgery

Objectives:  To compare the efficacy of peri-operative use of bupivacaine with corticosteroids versus bupivacaine alone in lumbar disc disease surgery. Materials and Methods:  This randomized controlled study at PIMS Hospital (Nov 2023–May 2024) involved 76 patients (ages 25–65) undergoing lumbar disc surgery. Patients with prior surgery, epidural steroids, spinal trauma, or rheumatoid arthritis were excluded. Group A received Gelfoam soaked in 10 mL of 0.25% bupivacaine + 2 mL dexamethasone, while Group B received Gelfoam with 10 mL of 0.25% bupivacaine only. Efficacy was assessed over 24 hours. Results:  Patients in Group A and B had mean ages of 43.08 ± 10.50 and 42.11 ± 10.22 years, respectively.  The majority of the 45 patients (59.21%) were in the 25–45 age range. The male-to-female ratio was 2.16:1, with 52 (68.42%) of the 76 cases being male and 24 (31.58%) being female. The mean baseline VAS score was 6.61 ± 1.03. The mean baseline VAS score in group A (corticosteroid and bupivacaine) was 6.47 ± 1.01 and the mean pre-therapy VAS score in group B (bupivacaine alone) was 6.74 ± 1.06. The efficacy of using bupivacaine and corticosteroids during lumbar disc disease surgery was found to be 30 (78.95%) as compared to 20 (52.63%) in the bupivacaine group only, with a 0.016 p-value. Conclusion:  The study concluded that the efficacy of peri-operative use of corticosteroid and bupivacaine is higher as compared to bupivacaine alone in lumbar disc disease surgery.