Efficacy of Periarticular Vasoconstrictor Infiltration (PVI) in Reducing Bleeding and Postoperative Pain in Lumbar Fusion Surgery: Retrospective Observational Study
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 发起方
- 入组人数
- 25
- 试验地点
- 1
- 主要终点
- Intraoperative blood loss
研究概览
简要总结
This retrospective observational study evaluates the efficacy of periarticular vasoconstrictor infiltration (PVI) in reducing intraoperative bleeding and postoperative pain in adult patients undergoing lumbar fusion surgery at Hospital de la Santa Creu i Sant Pau (Barcelona, Spain) from November 2024 to October 2025. PVI, introduced recently as an alternative to erector spinae plane (ESP) block, involves ultrasound-guided infiltration of local anesthetic with epinephrine in deep and superficial periarticular planes before surgery. The study includes all consecutive cases meeting inclusion criteria (lumbar fusion in adults), excluding incomplete records (expected n=25).
详细描述
Lumbar fusion surgery treats degenerative disc disease, spondylolisthesis, and lumbar stenosis when conservative management fails. It carries high risks of intraoperative bleeding (often requiring transfusion) and severe postoperative pain necessitating systemic opioids, impacting patient safety and recovery. Multimodal pain management and bleeding control are key challenges. Periarticular vasoconstrictor infiltration (PVI), inspired by tumescent anesthesia and WALANT techniques, has shown promise in reducing bleeding and improving analgesia in other orthopedic procedures. At Hospital de la Santa Creu i Sant Pau (Barcelona, Spain), PVI-ultrasound-guided infiltration of local anesthetic with epinephrine in deep/superficial periarticular planes was recently adopted preoperatively, replacing erector spinae plane (ESP) block, with promising clinical outcomes lacking formal retrospective analysis
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult patients undergoing lumbar fusion surgery who received PVI between November 2024-October 2025 at Hospital de Sant Pau
排除标准
- •Incomplete surgeries, incomplete clinical data, or poor quality anesthesia records.
研究组 & 干预措施
PVI Lumbar Fusion Patients
Patients treated with PVI during lumbar fusion surgery
干预措施: Periarticular Vasoconstrictor Infiltration (Other)
结局指标
主要结局
Intraoperative blood loss
时间窗: Perioperative
Total volume aspirated (mL) from surgical suction, minus irrigation volume
Postoperative pain intensity
时间窗: up to 24 hours
Numeric Verbal Scale (0-10) at 24 hours
次要结局
- Postoperative opioid consumption(up to 24 hours)
- Opioid-related adverse effects(up to 24 hours)
- Drain output(Perioperative)
- Need for blood transfusion(Perioperative)
- Length of hospital stay(Perioperative)
- Block-related and postoperative complications(Perioperarive)
研究者
MIREIA RODRIGUEZ PRIETO
Anesthesiologist specialized in Regional and Orthopedic Anesthesia at Hospital de Sant Pau, Barcelona"
Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau