Comparison of Postoperative Pain Control Methods in Patients with Spinal Stenosis after Posterior Spinal Decompression
10.4184/jkss.2018.25.3.122
- Author:
Woo Suk SONG
1
;
Young Sang LEE
;
Byoung Hark PARK
;
Jeong Muk KIM
;
Chan Woong BYUN
Author Information
1. Department of Orthopedic Surgery, Bundang Jesaeng General Hospital, Seongnam, Korea. yslee2808@gmail.com
- Publication Type:Original Article
- Keywords:
Postoperative pain control;
IV-PCA;
SEI;
CEI
- MeSH:
Analgesia;
Analgesia, Patient-Controlled;
Decompression;
Humans;
Injections, Epidural;
Methods;
Nausea;
Pain, Postoperative;
Passive Cutaneous Anaphylaxis;
Postoperative Nausea and Vomiting;
Prospective Studies;
Spinal Stenosis;
Vomiting
- From:Journal of Korean Society of Spine Surgery
2018;25(3):122-127
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: Prospective study. OBJECTIVES: This study compared the early postoperative analgesic effects and the postoperative nausea and vomiting (PONV) associated with 3 methods of pain control after posterior spinal decompression. SUMMARY OF LITERATURE REVIEW: Spinal surgery causes severe postoperative pain. Efficient and safe methods for postoperative analgesia after spinal surgery are necessary. MATERIALS AND METHODS: To determine the clinical symptoms and to assess improvements in postoperative pain, 52 patients in whom single-level posterior lumbar decompression was planned were randomly assigned to 3 groups. For postoperative pain control, 18 patients received a preoperative single-shot epidural injection (SEI), 16 patients received a postoperative continuous epidural injection (CEI), and 18 patients received only postoperative intravenous patient-controlled analgesia (IV-PCA). Patient ratings of pain intensity (visual analog scale score from 0 [no pain] to 10 [most severe pain]), nausea (from 0 [no nausea] to 5 [severe nausea]), and vomiting (from 0 [no vomiting] to 5 [severe vomiting]) were recorded immediately after the operation and at 4 hours, 12 hours, 1 day, and 2 days postoperatively. RESULTS: The CEI group showed significantly enhanced analgesic effects, followed by the SEI group and the IV PCA group (p < 0.05). PONV due to postoperative pain control was more severe in the IV PCA group than in the other 2 groups (p < 0.05). CONCLUSIONS: Continuous epidural injection (CEI) is effective for postoperative pain control and minimizes the occurrence of PONV after posterior spinal decompression.
