In Reply: Bupivacaine Field Block With Clonidine for Postoperative Pain Control in Posterior Spine Approaches: A Randomized Double-Blind Trial

In Reply: Bupivacaine Field Block With Clonidine for Postoperative Pain Control in Posterior... CORRESPONDENCE clonidine group 86.1 ± 11.0% when compared to the control In Reply: Bupivacaine Field Block With group 68.7 ± 14.2 (P < .001). However, this outcome measure Clonidine for Postoperative Pain Control in was not included in the original manuscript since it is not a Posterior Spine Approaches: A Randomized validated instrument. Double-Blind Trial To the Editor: Disclosures We considered with great interest this letter to the editor, Funding was from the research council of the Saint Joseph University of Beirut (FM 217). The authors have no personal, financial, or institutional interest in any including valuable remarks that could help clarifying some points of the drugs, materials, or devices described in this article. and providing further support to the findings of this clinical trial. The intraoperative analgesic protocol was detailed in the Previous Presentations Anesthetic and Surgical Protocol, as well as in the Postoperative This material was presented at the World Association of Lebanese Neuro- Hospital Stay sections. At induction, a bolus of 10 μgsufen- surgeon Congress, June 19-22, 2013, in Beirut, Lebanon as a plenary presen- tanil was delivered intravenously followed by boluses of 5 μg tation; the 8th Congress of the European Federation of IASP Chapters, October sufentanil, according to heart rate and mean arterial pressure. 9-12, 2013 in Florence, Italy as a poster presentation; the Annual Meeting of the Approximately 40 min before the end of surgery, all patients French Society of Neurosurgery, November 24-27, 2013, in Paris, France, as a received 15 mg/kg paracetamol and 1 mg/kg ketoprofen. In plenary presentation; and at the 21st Annual Meeting of the Lebanese Association for the Advance of Science, April 15-17, 2015, in Beirut, Lebanon, as a poster the postoperative period, all patients received a standardized presentation. analgesic protocol from the day of operation (D0) to the third postoperative day (D3), which consisted of intravenous injection of 1 g paracetamol with 50 mg ketoprofen every 6 h with ∗ ‡ Joseph Maarrawi, MD, PhD gastric protection. Rescue analgesic medication consisted of 5 ∗ ‡ Joe Abdel Hay, MD mg morphine subcutaneously administered upon patient request, Laboratory of Research in Neurosciences with a minimum interval of 6 h between 2 rescue morphine Faculty of Medicine (PTS) doses, and morphine consumption was considered as secondary St. Joseph University outcome measure. After D3, patients received oral paracetamol Beirut, Lebanon (1 g every 6 h) and ketoprofen (50 mg every 8 h) with gastric Department of Neurosurgery protection. Regarding the surgical duration parameter, it was Hôtel-Dieu de France hospital considered as an independent variable in the multivariate analysis. Beirut, Lebanon In the Results section, we only stated factors that influenced significantly the primary and secondary outcome measures. The duration of surgery did not affect significantly the outcome REFERENCES measures when tested for all patients and inside each group 1. Letter: Bupivacaine field block with clonidine for postoperative pain control in (clonidine and control group) in our study. The clinical signifi- posterior spine approaches: a randomized double-blind trial. Neurosurgery. 2018. cance of the analgesic difference reported in our clinical trial was doi: 10.1093/neuros/nyy162 [published online ahead of print]. 2. Abdel Hay J, Kobaiter-Maarrawi S, Tabet P, et al. Bupivacaine field block with not tested by a validated patient-centered instrument. However, clonidine for postoperative pain control in posterior spine approaches: a randomized we included in the design of our study an overall satisfaction double-blind trial. Neurosurgery. 2018; 82(6):790–798. score from 0 to 100 (0 meaning total dissatisfaction to 100 meaning complete satisfaction) of postoperative wound pain control. This patient satisfaction score measured at the end of 10.1093/neuros/nyy167 follow-up on postoperative D8 was significantly better in the NEUROSURGERY VOLUME 0 | NUMBER 0 | 2018 | 1 Downloaded from https://academic.oup.com/neurosurgery/advance-article-abstract/doi/10.1093/neuros/nyy167/4992746 by Ed 'DeepDyve' Gillespie user on 07 June 2018 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

In Reply: Bupivacaine Field Block With Clonidine for Postoperative Pain Control in Posterior Spine Approaches: A Randomized Double-Blind Trial

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Oxford University Press
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Copyright © 2018 by the Congress of Neurological Surgeons
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0148-396X
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1524-4040
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10.1093/neuros/nyy167
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Abstract

CORRESPONDENCE clonidine group 86.1 ± 11.0% when compared to the control In Reply: Bupivacaine Field Block With group 68.7 ± 14.2 (P < .001). However, this outcome measure Clonidine for Postoperative Pain Control in was not included in the original manuscript since it is not a Posterior Spine Approaches: A Randomized validated instrument. Double-Blind Trial To the Editor: Disclosures We considered with great interest this letter to the editor, Funding was from the research council of the Saint Joseph University of Beirut (FM 217). The authors have no personal, financial, or institutional interest in any including valuable remarks that could help clarifying some points of the drugs, materials, or devices described in this article. and providing further support to the findings of this clinical trial. The intraoperative analgesic protocol was detailed in the Previous Presentations Anesthetic and Surgical Protocol, as well as in the Postoperative This material was presented at the World Association of Lebanese Neuro- Hospital Stay sections. At induction, a bolus of 10 μgsufen- surgeon Congress, June 19-22, 2013, in Beirut, Lebanon as a plenary presen- tanil was delivered intravenously followed by boluses of 5 μg tation; the 8th Congress of the European Federation of IASP Chapters, October sufentanil, according to heart rate and mean arterial pressure. 9-12, 2013 in Florence, Italy as a poster presentation; the Annual Meeting of the Approximately 40 min before the end of surgery, all patients French Society of Neurosurgery, November 24-27, 2013, in Paris, France, as a received 15 mg/kg paracetamol and 1 mg/kg ketoprofen. In plenary presentation; and at the 21st Annual Meeting of the Lebanese Association for the Advance of Science, April 15-17, 2015, in Beirut, Lebanon, as a poster the postoperative period, all patients received a standardized presentation. analgesic protocol from the day of operation (D0) to the third postoperative day (D3), which consisted of intravenous injection of 1 g paracetamol with 50 mg ketoprofen every 6 h with ∗ ‡ Joseph Maarrawi, MD, PhD gastric protection. Rescue analgesic medication consisted of 5 ∗ ‡ Joe Abdel Hay, MD mg morphine subcutaneously administered upon patient request, Laboratory of Research in Neurosciences with a minimum interval of 6 h between 2 rescue morphine Faculty of Medicine (PTS) doses, and morphine consumption was considered as secondary St. Joseph University outcome measure. After D3, patients received oral paracetamol Beirut, Lebanon (1 g every 6 h) and ketoprofen (50 mg every 8 h) with gastric Department of Neurosurgery protection. Regarding the surgical duration parameter, it was Hôtel-Dieu de France hospital considered as an independent variable in the multivariate analysis. Beirut, Lebanon In the Results section, we only stated factors that influenced significantly the primary and secondary outcome measures. The duration of surgery did not affect significantly the outcome REFERENCES measures when tested for all patients and inside each group 1. Letter: Bupivacaine field block with clonidine for postoperative pain control in (clonidine and control group) in our study. The clinical signifi- posterior spine approaches: a randomized double-blind trial. Neurosurgery. 2018. cance of the analgesic difference reported in our clinical trial was doi: 10.1093/neuros/nyy162 [published online ahead of print]. 2. Abdel Hay J, Kobaiter-Maarrawi S, Tabet P, et al. Bupivacaine field block with not tested by a validated patient-centered instrument. However, clonidine for postoperative pain control in posterior spine approaches: a randomized we included in the design of our study an overall satisfaction double-blind trial. Neurosurgery. 2018; 82(6):790–798. score from 0 to 100 (0 meaning total dissatisfaction to 100 meaning complete satisfaction) of postoperative wound pain control. This patient satisfaction score measured at the end of 10.1093/neuros/nyy167 follow-up on postoperative D8 was significantly better in the NEUROSURGERY VOLUME 0 | NUMBER 0 | 2018 | 1 Downloaded from https://academic.oup.com/neurosurgery/advance-article-abstract/doi/10.1093/neuros/nyy167/4992746 by Ed 'DeepDyve' Gillespie user on 07 June 2018

Journal

NeurosurgeryOxford University Press

Published: May 4, 2018

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