Postoperative laminectomy pain control using bupivacaine and epidural morphine

In a prospective double blind study, 26 patients were evaluated for postoperative pain relief with use of epidural morphine. The variable in this study was the addition of paravertebral bupivacaine used in 14 patients. The addition of the bupivacaine did not have a statistically significant effect on lowering the analgesic requirement during the first 36 hours after surgery, the total dose of medication required during hospitalization, nor the time to the onset of supplemental pain medicine requirement. There were no problems with late respiratory depression. We conclude that the addition of paravertebral bupivacaine is not effective in decreasing the amount of pain medication that is required in lumbar laminectomy patients and adds very little to patients already receiving epidural narcotics.