Effects of postoperative local incision injection of different local anesthetics on analgesia after posterior lumbar discectomy

XIONG Peng-dao; MO Feng-bo; WANG Kai-yun; QI Qi-hua; LAI Qi; ZHANG Bin; GUO Run-sheng

doi:10.13820/j.cnki.gdyx.20252041

Abstract：Objective To compare the postoperative analgesic effects of liposomal bupivacaine and ropivacaine in patients undergoing open posterior lumbar discectomy.Methods A total of 100 patients who underwent open posterior lumbar discectomy between April 2024 and February 2025 were randomly assigned to the liposomal bupivacaine group(n=50)or the ropivacaine group(n=50).The liposomal bupivacaine group received local incision injection of liposom-al bupivacaine combined with patient-controlled intravenous analgesia(PCIA),while the ropivacaine group received lo-cal incision injection of ropivacaine combined with PCIA.Postoperative analgesic outcomes and opioid consumption were assessed.Results Compared with the ropivacaine group,the liposomal bupivacaine group showed no significant differ-ence in visual analogue scale(VAS)score at 1 h postoperatively,but had significantly lower VAS scores at 6,12,24,48,and 72 h(P＜0.05).The liposomal bupivacaine group had a shorter postoperative hospital stay[(3.91±0.20)days vs.(4.16±0.24)days]and lower opioid-equivalent consumption(82.10±6.12 vs.93.00±9.91),both statisti-cally significant(t=5.565,P＜0.05;t=6.614,P＜0.05).Satisfaction with analgesia was higher in the liposomal bupivacaine group(9.1±0.68 vs.8.7±0.86;t=2.578,P=0.013).No significant differences were observed in hour-ly PCIA activation,time to first ambulation,operative time,intraoperative blood loss,or adverse events(P＞0.05).Conclusion Local incision injection of liposomal bupivacaine provides superior postoperative analgesia and higher patient satisfaction compared with ropivacaine in posterior lumbar discectomy.It shortens hospital stay and reduces postoperative opioid consumption,supporting its broader clinical application.