(157) Postoperative pain catastrophizing and pressure pain sensitivity as risk factors for persistent pain and disability in patients after lumbar spine surgery

AIMS AND OBJECTIVES: To evaluate the efcacy of duloxetine in different doses in postoperative pain relief in patients undergoing lumbar spine surgery. MATERIALAND METHOD: 80 patients of ASA grade І & ІІ of either sex scheduled for lumbar spine surgery under general anaesthesia were divided into 2 groups (n=40 each) randomly.Group D (n=40) Patients who received a 60 mg duloxetine 1 hour before surgery and another tablet the following morning. Group 'P'(n=40) Patients who received a placebo tablet 1 hour before surgery and again the following morning. Pulse rate, blood pressure, respiratory rate and severity of pain on NRS scale was noted at 0 hr, 4 hr, 8 hr, 12 hr, 16 hr, 20 hr, 24 hr, 28 hr, 32 hr and 48 hr after surgery. And the presence or absence of adverse effects, such as headache, nausea, vomiting, dizziness, and drowsiness were noted. RESULT: Analysis revealed that time for rst analgesic requirement was signicantly longer with oral Duloxetine 60 mg than with placebo. Pre-emptive oral Duloxetine 60 mg decreases the severity of pain postoperatively but not signicantly as compared to placebo in patients posted for lumbar spine surgery under general anaesthesia. Oral Duloxetine 60 mg had no signicant effect on cardiovascular and respiratory parameters. Patients receiving duloxetine had higher incidence of nausea, vomiting. CONCLUSION:that time for rst analgesic requirement was signicantly longer with oral Duloxetine 60 mg than placebo.

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The Clinical Efficacy of Piroxicam Fast-Dissolving Dosage Form for Postoperative Pain Control After Simple Lumbar Spine Surgery

Spine ◽

10.1097/00007632-200203010-00002 ◽

2002 ◽

Vol 27 (5) ◽

pp. 447-451 ◽

Cited By ~ 6

Author(s):

Chathchai Pookarnjanamorakot ◽

Wichien Laohacharoensombat ◽

Suphaneewan Jaovisidha

Keyword(s):

Lumbar Spine ◽

Postoperative Pain ◽

Clinical Efficacy ◽

Spine Surgery ◽

Pain Control ◽

Dosage Form ◽

Lumbar Spine Surgery ◽

Postoperative Pain Control

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Incidence and Risk Factors for Postoperative Delirium After Lumbar Spine Surgery

Spine ◽

10.1097/brs.0b013e3182a0d507 ◽

2013 ◽

Vol 38 (20) ◽

pp. 1790-1796 ◽

Cited By ~ 69

Author(s):

Steven J. Fineberg ◽

Sreeharsha V. Nandyala ◽

Alejandro Marquez-Lara ◽

Matthew Oglesby ◽

Alpesh A. Patel ◽

...

Keyword(s):

Risk Factors ◽

Lumbar Spine ◽

Spine Surgery ◽

Postoperative Delirium ◽

Lumbar Spine Surgery

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Is a Single Low Dose of Intrathecal Morphine a Useful Adjunct to Patient-Controlled Analgesia for Postoperative Pain Control Following Lumbar Spine Surgery? A Preliminary Report

Pain Research and Management ◽

10.1155/2015/761390 ◽

2015 ◽

Vol 20 (3) ◽

pp. 129-132 ◽

Cited By ~ 9

Author(s):

David Yen ◽

Kim Turner ◽

David Mark

Keyword(s):

Lumbar Spine ◽

Postoperative Pain ◽

Respiratory Depression ◽

Spine Surgery ◽

Pain Control ◽

Low Dose ◽

Intrathecal Morphine ◽

Lumbar Spine Surgery ◽

Patient Controlled Analgesia ◽

Postoperative Pain Control

BACKGROUND: Several studies addressing intrathecal morphine (ITM) use following spine surgery have been published either involving the pediatric population, using mid- to high-dose ITM, or not in conjunction with morphine patient-controlled analgesia (PCA).OBJECTIVES: To determine whether low-dose ITM is a useful adjunct to PCA for postoperative pain control following elective lumbar spine surgery in adults.METHODS: Thirty-two patients were enrolled in a double-blinded randomized controlled trial, and received either ITM or intrathecal placebo. Postoperatively, all patients were given a PCA pump and observed for the first 24 h in a step-down unit. Measurements of: total PCA morphine consumed in the first 24 h; intensity of pain; pruritus; nausea at 4 h, 8 h and 24 h; time to first ambulation; length of hospital stay; and occurrences of respiratory depression were recorded.RESULTS: The total PCA use was significantly lower in the ITM group. There were lower average pain scores in the ITM group, which increased to that of the intrathecal placebo group over 24 h; however, this failed to attain statistical significance. There were no differences in nausea, pruritus, time to first ambulation or hospital length stay. There were no cases of respiratory depression in either group.CONCLUSIONS: ITM may be a useful adjunct to PCA, but did not decrease time to ambulation or length of stay.

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