Comparison of Postoperative Pain Control Methods in Patients with Spinal Stenosis after Posterior Spinal Decompression (후방 척추 감압술을 시행한 척추관 협착증 환자에서 수술 후 통증조절 방법간의 효과 비교)

송우석; Young-Sang Lee (이영상); 박병학; 김정묵; 변찬웅

Comparison of Postoperative Pain Control Methods in Patients with Spinal Stenosis after Posterior Spinal Decompression

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2018, 25(3), pp.122-127
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

송우석 ¹, Young-Sang Lee ¹, 박병학 ², 김정묵 ¹, 변찬웅 ¹

¹분당제생병원 정형외과
²분당제생병원 마취통증의학과

Accredited

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.

KEYWORDS

Postoperative pain control, IV-PCA, SEI, CEI

Citation status

* References for papers published after 2023 are currently being built.

[journal] Bianconi M / 2004 / The pharmacokinetics and efficacy of ropivacaine continuous wound instillation after spine fusion surgery / Anesth Analg 98(1) : 166~172

[journal] Cassady JF Jr / 2000 / A randomized comparison of the effects of continuous thoracic epidural analgesia and intravenous patient-controlled analgesia after posterior spinal fusion in adolescents / Reg Anesth Pain Med 25(3) : 246~253

[journal] Preble L / 1990 / Varying narcotic requirements among orthopedic patients / Anesthesiology 73

[journal] Blumenthal S / 2005 / Double epidural catheter with ropivacaine versus intravenous morphine: a comparison for postoperative analgesia after scoliosis correction surgery / Anesthesiology 102(1) : 175~180

[journal] Eilers K / 2002 / Use of peridural catheters in the treatment of postoperative pain after spinal instrumented fusion–an experience report / Z Orthop Ihre Grenzgeb 140(6) : 621~625

[journal] Lowry KJ / 1976 / Postoperative pain control using epidural catheters after anterior spinal fusion for adolescent scoliosis / Spine (Phila Pa 1976) 26(11) : 1290~1293

[journal] Byung Joon Shin / 1994 / The Effect of Epidural Morphine for pain Management after Spinal Surgery / J Korean Soc Spine Surg 1(2) : 216~222

[journal] Ferrante FM / 1988 / A statistical model for pain in patient controlled analgesia and conventional intramuscular opioid regimens / Anesth Analg 67(5) : 457~461

[journal] Harrison DM / 1988 / Epidural narcotic and patient controlled analgesia for post-cesarean section pain relief / Anesthesiology 68(3) : 454~457

[journal] Egbert AM / 1990 / Randomized trial of postoperative patient-controlled analgesia vs. intramuscular narcotics in frail elderly man / Arch Intern Med 150(9) : 1897~1903

[journal] Sechzer PH / 1990 / Patient-controlled analgesia (PCA): a retrospective / Anesthesiology 72(4) : 735~736

[journal] Behar M / 1979 / Epidural morphine in treatment of pain / Lancet 1(8115) : 527~529

[journal] Joshi GP / 1995 / Postoperative analgesia after lumbar laminectomy: epidural fentanyl infusion versus patient-controlled intravenous morphine / Anesth Analg 80(3) : 511~514

[journal] Shaw BA / 1996 / The safety of continuous epidural infusion for postoperative analgesia in pediatric spine surgery / J Pediatr Orthop 16(3) : 374~377

[journal] Turner A / 2000 / The efficacy of surgically placed epidural catheters for analgesia after posterior spinal surgery / Anaesthesia 55(4) : 370~373

[journal] Schenk Michael R / 2006 / Postoperative analgesia after major spine surgery: patientcontrolled epidural analgesia versus patient-controlled intravenous analgesia / Anesth Analg 103(5) : 1311~1317

[journal] Wu Meng-Huang / 1976 / A comparison of three types of postoperative pain control after posterior lumbar spinal surgery / Spine (Phila Pa 1976) 36(25) : 2224~2231

[journal] Klatt Joshua W. B. / 1976 / A randomized prospective evaluation of 3 techniqued of post operative pain management after posterior spinal intrumentation and fusion / Spine (Phila Pa 1976) 38(19) : 1626~1631

[journal] Maurer K / 2003 / Continuous spinal anesthesia/analgesia vs. single-shot spinal anesthesia with patient-controlled analgesia for elective hip arthroplasty / Acta Anaesthesiol Scand 47(7) : 878~883

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