Comparison of post-operative analgesic length of Extradural Bupivacaine and Paracetamol individually and in a combination in patients undergoing major spinal surgery

Spine surgery is one of the most common major surgeries for patients with spine disorders. Postoperative pain after major spine surgery is moderate to severe. The aim of this study is to compare duration of analgesia with bupivacaine and intravenous paracetamol alone and in combination in patients undergoing major surgery of the spine after surgery.
In this double blinded randomized clinical trial, 150 patients with elective spine surgery were divided randomly into three groups (n=50). Paracetamol group: Intravenous infusion of 15 mg / kg paracetamol 20 minutes before the end of surgery and normal saline as placebo poured by the surgeon on extradural, bupivacaine group: bupivacaine 0.125% 10 ml poured by the surgeon on extradural and intravenous infusion of 100 ml normal saline 20 minutes before the end of surgery and paracetamol plus bupivacaine group : bupivacaine 0.125% 10 ml poured by the surgeon on extradural and intravenous infusion of 15 mg / kg paracetamol 20 minutes before the end of surgery. Hemodynamic parameters, pain scores immediately after surgery , 30 and 180 minutes after surgery, duration of analgesia, the incidence of side effects ( nausea, vomiting , itching ), opioid consumption and the first time of analgesic request were recorded.
Systolic, diastolic, mean arterial pressure, heart rate and pain score showed no significant changes at the designated time points between three groups (p>0.05). No Side effects were reported in any of the patients.
It seems that intravenous infusion of15 mg / kg paracetamol with bupivacaine 0.125% 10 ml poured by surgeon on extradural area, in major spine surgery lead to increase of hemodynamic stability, prolonged duration of analgesia and reduction of side effects related to opioids.