Protocol for Testing Yoga to Reduce Post–Lumbar Spine Surgery Pain: A Methodology Article

Author(s):  
Neena K. Sharma ◽  
Kosaku Aoyagi ◽  
Mary K. Crouch Young ◽  
Alyssa Parrish ◽  
Carol Smith ◽  
...  

Abstract Currently, acute postoperative pain during hospitalization is primarily managed by medications, and patients must adhere to restrictive postoperative precautions for 3 months following lumbar spine surgeries. Yoga can be an alternative approach to assist in acute and subacute postoperative pain management, anxiety, and return to function. The purpose of the present work was to develop and test the feasibility and explore the effectiveness of a tailored yoga program, delivered in-person during the hospital stay and electronically after hospital discharge, as a potential new avenue for postoperative care. This pilot study will use a crossover randomized controlled design. Individuals aged between 40 and 80 years who are scheduled for lumbar laminectomy and/or fusion, and who have not practiced regular yoga within the past 6 months at the time of enrollment, will be recruited and randomized to either a tailored yoga program (intervention group) or usual care (control group) during the hospital stay (phase one). Bearing in mind postoperative precautions, all subjects will be instructed to perform a home-based tailored yoga program delivered electronically via YouTube links for 8 weeks post-hospital discharge (phase two). The primary outcome measures assessing feasibility are adherence/compliance. Secondary outcome measures include pain, anxiety, function, sleep, perceived stress, and pain-catastrophizing behavior. Length of hospital stay and pain medication use, gait distance, and overall physical activity during hospitalization will also be collected. Finally, a qualitative interview will be obtained after completion of the hospital and home-based programs. This study will determine the feasibility of a tailored yoga program for acute and subacute postoperative lumbar spine surgery pain, anxiety, and functional outcomes.

2021 ◽  
pp. 76-77
Author(s):  
Deepti Chauhan ◽  
Satyendra Yadav ◽  
Heena Sheikh ◽  
Ashish Mathur

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.


2015 ◽  
Vol 20 (3) ◽  
pp. 129-132 ◽  
Author(s):  
David Yen ◽  
Kim Turner ◽  
David Mark

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.


2008 ◽  
Vol 20 (4) ◽  
pp. 256-260 ◽  
Author(s):  
Juan P. Cata ◽  
Edward M. Noguera ◽  
Emily Parke ◽  
Zeyd Ebrahim ◽  
Andrea Kurz ◽  
...  

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 245-246
Author(s):  
John Thomas Pierce ◽  
Prateek Agarwal ◽  
Paul J Marcotte ◽  
William Charles Welch

Abstract INTRODUCTION Lumbar spine surgery can be successfully performed using various anesthetic techniques. Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia (SA) to general anesthesia (GA) in lumbar surgery. We sought to elucidate the more expedient anesthetic technique. METHODS Following IRB approval, a retrospective review of patients undergoing elective lumbar decompression surgery using GA or SA was performed. Demographic data known to influence perioperative morbidity was collected as well as safety and efficiency parameters. After controlling for patient and procedure characteristics, simple linear and multivariate regression analyses were performed to identify differences in operative blood loss, operative time, time from entering the OR until incision, time from bandage placement to exiting the OR, total anesthesia time, time in the post-anesthesia care unit (PACU), and length of hospital stay. RESULTS >544 consecutive lumbar laminectomy and discectomy surgeries were identified with 183 undergoing GA and 361 undergoing SA. The following times were all shorter for patients receiving SA than GA: operative time (97.4 vs. 151.8 min., P < 0.001), total anesthesia time (145.6 vs. 217.5 min., P < 0.001), time from entering the OR until incision (38.3 vs. 46.8 min., respectively, P < 0.001), time from bandage placement until exiting the OR (10.2 vs. 17.2 min., P < 0.001), and length of hospital stay (1.5 vs. 3.1 days, P < 0.001). The mean PACU length of stay was longer in the SA group than the GA group (178.0 vs. 116.5 min., P < 0.001). Estimated blood loss was less in the SA group than the GA group (62.1 vs. 176.3 mL, P < 0.001). CONCLUSION Spinal anesthesia may be the more expedient method of anesthesia in lumbar spinal surgery for all perioperative time points except for time in the PACU.


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