Patient-controlled Epidural Analgesia (PCEA) for Postoperative Pain Control After Lumbar Spine Surgery

2008 ◽  
Vol 20 (4) ◽  
pp. 256-260 ◽  
Author(s):  
Juan P. Cata ◽  
Edward M. Noguera ◽  
Emily Parke ◽  
Zeyd Ebrahim ◽  
Andrea Kurz ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Spine Surgery ◽  
Pain Control ◽  
Lumbar Spine Surgery ◽  
Postoperative Pain Control

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

Spine ◽  
2002 ◽  
Vol 27 (5) ◽  
pp. 447-451 ◽  
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

scholarly journals 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

2015 ◽  
Vol 20 (3) ◽  
pp. 129-132 ◽  
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.

Peridural Methylprednisolone and Wound Infiltration With Bupivacaine for Postoperative Pain Control After Posterior Lumbar Spine Surgery

Spine ◽  
2007 ◽  
Vol 32 (6) ◽  
pp. 609-616 ◽  
Author(s):  
Kitti Jirarattanaphochai ◽  
Surachai Jung ◽  
Somboon Thienthong ◽  
Wimonrat Krisanaprakornkit ◽  
Chat Sumananont
Keyword(s):  
Lumbar Spine ◽  
Postoperative Pain ◽  
Spine Surgery ◽  
Pain Control ◽  
Lumbar Spine Surgery ◽  
Postoperative Pain Control ◽  
Wound Infiltration

“A COMPARATIVE STUDY TO EVALUATE THE EFFICACY OF DULOXETINE IN POSTOPERATIVE PAIN RELIEF IN PATIENTS IN UNDERGOING LUMBAR SPINE SURGERY ”

2021 ◽  
pp. 76-77
Author(s):  
Deepti Chauhan ◽  
Satyendra Yadav ◽  
Heena Sheikh ◽  
Ashish Mathur
Keyword(s):  
Lumbar Spine ◽  
Postoperative Pain ◽  
Pain Relief ◽  
General Anaesthesia ◽  
Spine Surgery ◽  
Postoperative Pain Relief ◽  
Lumbar Spine Surgery ◽  
Analgesic Requirement ◽  
Respiratory Parameters ◽  
Result Analysis

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.

scholarly journals Local infiltration vs epidural analgesia for postoperative pain control after total knee or hip arthroplasty

Medicine ◽  
2020 ◽  
Vol 99 (44) ◽  
pp. e22674
Author(s):  
Xian Liu ◽  
Haijing Zhang ◽  
Huan Zhang ◽  
Mengzhuo Guo ◽  
Yuanchao Gao ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Hip Arthroplasty ◽  
Pain Control ◽  
Postoperative Pain Control ◽  
Local Infiltration ◽  
Total Knee

scholarly journals Development and Validation of a Clinical Prediction Score for Poor Postoperative Pain Control Following Elective Spine Surgery

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Michael M H Yang ◽  
Jay Riva-Cambrin ◽  
Jonathan Cunningham ◽  
Nathalie Jette ◽  
Tolulope T Sajobi ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Prediction Model ◽  
Spine Surgery ◽  
Pain Control ◽  
Goodness Of Fit ◽  
Rating Scale ◽  
Clinical Care ◽  
Risk Groups ◽  
Research Network ◽  
Postoperative Pain Control

Abstract INTRODUCTION Approximately, 30% to 64% of people suffer from poorly controlled pain following spine surgery leading to patient dissatisfaction and poor outcomes. The ability to identify these patients before surgery may be useful to facilitate patient education and the development of personalized clinical-care pathways to improve postoperative pain management. METHODS Adult patients were consecutively enrolled through the Canadian Spine Outcomes and Research Network registry and were included if they underwent inpatient elective cervical or thoracolumbar spine surgery. The outcome was poor postoperative pain control defined as the mean numeric rating scale for pain >4 in the first 24-h after surgery. A split-sample design was used to develop and validate the prediction model. The prediction model was transformed into a risk-based score and simplified to a 3-tier Calgary Postoperative Pain after Spine Surgery (CAPPS) score to maximize clinical utility. RESULTS Of 1300 patients, 57% had poorly controlled pain following spine surgery. Seven significant predictors were associated with poor pain control: younger age, female sex, preoperative daily opioid medication use, higher preoperative neck or back pain intensity, higher PHQ-9 depression score, > = 3 motion segment operation, and fusion surgery. Notably, chronic pain and minimally invasive surgery were not associated with pain control status. The model was discriminative (c-statistics 0.74 [95% CI = 0.71-0.77]) and accurate (Hosmer-Lemeshow goodness-of-fit, P = .99) at predicting the outcome. Patients classified to low-, high-, and extreme-risk groups by the CAPPS score had 32%, 63%, and 85% predicted probability of developing poor postoperative pain control, respectively. This closely mirrored the observed probability of 37%, 62%, and 81% in the same risk-groups for poor pain control in the validation cohort. CONCLUSION This internally validated CAPPS score based on 7 easily acquired characteristics accurately predicted the probability of developing poor pain control after spine surgery. This score can be used to develop personalized preoperative and perioperative treatment strategies to improve pain outcomes.

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