Mini:

Bleeding and pain following lumbar fusion surgery remains a challenge for orthopedists. We designed a prospective, randomized, double-blind controlled trial and confirmed that the topical application of multifunctional cocktail we designed provide an effective and safe method for simultaneously reducing pain and bleeding after spinal fusion.

Study design:

A prospective, randomized, double-blind controlled trial.

Objective:

To explore the effect of multifunctional cocktail for bleeding and pain control after spinal fusion.

Summary of background data:

Managing postoperative bleeding and pain following spinal fusion remains a challenge. Topical application of tranexamic acid (TXA) or anaesthetic agents for bleeding or pain management just started recently, and the multifunctional cocktail for bleeding and pain control simultaneously after spinal fusion have never been published.

Methods:

90 patients who underwent posterior spinal fusion were enrolled in this study. The multifunctional cocktail was injected into the incision before wound closure in the cocktail group. In the control group, an equal volume of normal saline was injected and a patient-controlled analgesic (PCA) pump was used. Visual analogue scale (VAS) score; opioid consumption; intraoperative, postoperative, hidden and total blood loss (IBL, PBL, HBL, and TBL); volume of drainage (WD), haematocrit (Hct) levels of drainage; haemoglobin (Hb) levels; and complications were compared between the two groups.

Results:

There were no differences in the VAS within 48 h after surgery between the two groups. However, the opioid dosages in the control group were higher than those in the cocktail group. The PBL, TBL and HBL were lower in the cocktail group than in the control group. The drainage volume showed no differences between the two groups; however, the Hct level of drainage at 24 h after surgery was lower in the cocktail group than in the control group. The Hb level was higher in the cocktail group than in the control group at POD3. Thirteen patients with unbearable nausea and vomiting in the control group, while no complications in the cocktail group.

Conclusion:

Topical application of a multifunctional cocktail that we designed provides an effective and safe method for reducing pain and bleeding after spinal fusion.Level of Evidence: 1.