Prophylactic use of platelet-rich plasma for post-spinal low back pain following gynecological surgery: a randomized clinical trial

Assiut University, Intensive Care and Pain Department, Assiut, Egypt. Electronic address: ghadafadl@aun.edu.eg. Assiut University, Faculty of Medicine, Intensive Care and Pain Department, Assiut, Egypt. Assiut University, Intensive Care and Pain Department, Assiut, Egypt. Assiut University, Faculty of Medicine, Clinical Pathology Department, Assiut, Egypt. Assiut University, Faculty of Medicine, Obstetrics & Gynecology Department, Assiut, Egypt.

Brazilian journal of anesthesiology (Elsevier). 2021
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Abstract
BACKGROUND Post-spinal back pain is suggested to occur as a result of a localized inflammatory response that is often associated with some degree of muscle spasm. We aimed to evaluate the effect of platelet-rich plasma (PRP) in reducing the incidence of post-spinal back pain. METHODS One hundred patients were randomly enrolled and scheduled for elective gynecological surgery under spinal anesthesia. After the subarachnoid block, group A (placebo) received 2 mL of sodium chloride 0.9% injected into the track of spinal needle during its withdrawal (2 mm after outward withdrawal in muscles and subcutaneous tissues). While patients in group B (PRP); received 2 ml of PRP injected into the track of the spinal needle during its withdrawal. The primary outcome was the number of patients who developed post-spinal low back pain within the first week following the subarachnoid block. Secondary outcomes included the time of the first analgesic request and total meperidine consumption during the first 24 h postoperatively. RESULTS Fifteen patients in the PRP group developed low back pain during the first week following subarachnoid block compared to 26 patients in the placebo group (p = 0.037). There was a significant decrease in the mean meperidine consumption during first 24 h postoperatively in PRP group (174 ± 14 mg) compared to placebo group (210 ± 22 mg) (p < 0.0001). Also, the first analgesic request was significantly delayed in PRP group (243 ± 21 min.) compared to placebo group (185 ± 31 min.) (p < 0.0001). CONCLUSION This study demonstrated the positive effects of platelet-rich plasma on the prevention of post-spinal backache.
Study details
Language : eng
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