Epidural administration of
steroids has been suggested for the prevention of postoperative epidural
fibrosis after lumbar lamino-arthrectomy. In order to assess the efficacy of this technique on
pain occurring after such surgery, the demand of
pentazocine during the first 24 postoperative hours was studied in 39 patients randomly assigned to two groups.
Pain intensity was assessed by a five-point verbal scale (0: none; 1: poor; 2: moderate; 3: severe; 4: very severe) at five intervals (0-4, 5-8, 9-12, 13-16 and 17-24 h). The patients in group T (n = 20) did not receive any
steroid, whereas those in group C (n = 19) were given, just after the end of surgery, a single dose of
dexamethasone (4 mg) via an epidural lumbar
catheter previously inserted by the surgeon. In group
T, 18 patients required one or several
intramuscular injections of
pentazocine, whereas only three patients of group C (p less than 0.001) did so. Patients in group T expressed more severe
pain (4 moderate, 12 severe, 3 unbearable) than those patients who had received
steroids (1 moderate, 1 severe, 1 unbearable). As a consequence, they requested more
pain killer (30
injections vs 8
injections, respectively; p less than 0.001) and sooner than patients of the
steroid group (8 h vs 12 h; p less than 0.05). It was concluded that epidural administration of
dexamethasone was helpful in preventing
postoperative pain after lumbar lamino-arthrectomy.