Faculty Opinions recommendation of Intraoperative methadone improves postoperative pain control in patients undergoing complex spine surgery.

2011 ◽  
Author(s):  
Darin Correll ◽  
Antje Barreveld
Keyword(s):  
Postoperative Pain ◽  
Spine Surgery ◽  
Pain Control ◽  
Postoperative Pain Control

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.

Anesthesia and postoperative pain control following spine surgery

2018 ◽  
Vol 30 (3) ◽  
pp. 154-159 ◽  
Author(s):  
Michael T. Nolte ◽  
Islam M. Elboghdady ◽  
Sravisht Iyer
Keyword(s):  
Postoperative Pain ◽  
Spine Surgery ◽  
Pain Control ◽  
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.

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

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

scholarly journals The optimal dose of dexmedetomidine added to an sufentanil-based analgesic regimen for postoperative pain control in spine surgery

Medicine ◽  
2016 ◽  
Vol 95 (39) ◽  
pp. e4776 ◽  
Author(s):  
Chun-Shan Dong ◽  
Yao Lu ◽  
Jun Zhang ◽  
Peng Sun ◽  
Jun-Ma Yu ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Spine Surgery ◽  
Pain Control ◽  
Optimal Dose ◽  
Postoperative Pain Control ◽  
Analgesic Regimen
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