Head Injury and Neuroanesthesia

A Comparison of Three Types of Postoperative Pain Control After Posterior Lumbar Spinal Surgery

Wu M-H, Wong C-H, Niu C-C, et al (Chang Gung Memorial Hosp at Chiayi, Taiwan; Chang Gung Memorial Hosp at Linkou, Taoyuan, Taiwan) Spine 36:2224-2231, 2011^§

Abstract

Study Design

Retrospective, nonrandomized, comparative study.

Objective

This study compared the early postoperative analgesic effects and the postoperative nausea and vomiting (PONV) associated with three methods of pain control after posterior lumbar spinal surgery.

Summary of Background Data

The use of opioids for postoperative pain control is common after spinal surgery; however, PONV is the most frequently encountered side effect, and it is yet to be overcome. The effectiveness of the use of an absorbable low-dose morphine-soaked microfibrillar collagen hemostatic sponge placed on the surface of the dural sac (epidural MMCHS) was compared to patient-controlled analgesia (PCA) and intermittent intramuscular bolus injection of meperidine for postoperative pain control after spine surgery.

Methods

One hundred sixty-five patients who underwent short-segment posterior lumbar spinal decompression and fusion surgery between January 2007 and July 2007 in the orthopedic department of a medical center were enrolled. For postoperative pain control, 40 patients received epidural MMCHS, 48 patients received PCA, and 77 patients received meperidine injection. 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 at 4 hours postoperation and on postoperative days 1, 2, and 3.

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