The Effect of Preoperative Epidural Analgesia with Intravenous Patient-controlled Analgesia (IV-PCA) for Postoperative Pain Control in Bone Fusion and Pedicle Screw Fixation.
10.4097/kjae.2007.52.3.296
- Author:
Kyu Dae SHIM
1
;
Sang Ho LEE
;
Kyung Il HWANG
;
Kwang Hee KIM
Author Information
1. Departments of Anesthesiology and Pain Medicine and *Neurosurgery, Wooridul Spine Hospital, Seoul, Korea. skdphd@naver.com
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
epidural analgesia;
intravenous patient-controlled analgesia;
morphine;
ropivacaine
- MeSH:
Analgesia, Epidural*;
Analgesia, Patient-Controlled*;
Epidural Space;
Humans;
Incidence;
Morphine;
Pain, Postoperative*;
Prone Position;
Pruritus
- From:Korean Journal of Anesthesiology
2007;52(3):296-300
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Postoperative pain control following bone fusion and pedicle screw fixation is insufficient with IV-PCA alone. Therefore, the effect of preoperative epidural analgesia in addition to IV-PCA was evaluated for postoperative pain control following bone fusion and pedicle screw fixation surgery. METHODS: Eighty patients, scheduled to undergo bone fusion and pedicle screw fixation, were randomly assigned to two groups; the study (n = 40) or control groups (n = 40). After induction, the patient was turned into the prone position, and morphine 2 mg and 10 ml of 0.2% ropivacaine were injected into the L1/2 epidural space, after dye confirmation, under C-arm guidance for the study group, with 10 ml normal saline injected into the L1/2 epidural space for the control group. After induction, IV-PCA was applied in both groups. After the operation, the NRS (numerical rating scale) and side effects were evaluated immediately post-op, and at 24 and 48 hours after the operation. RESULTS: In the study group, the NRS was more reduced for all periods compared with the control group, but the incidences of nausea/vomiting and pruritus were no different from the control group. CONCLUSIONS: It was concluded that preoperative epidural analgesia, in addition to IV-PCA, was a good postoperative pain control method following bone fusion and pedicle screw fixation.
