No Difference in Pain After Spine Surgery with Local Wound Filtration of Morphine and Ketorolac: A Randomized Controlled Trial.

Clinical Orthopaedics and Related Research
Weerasak SinghatanadgigeWorawat Limthongkul

Abstract

Controlling postoperative pain after spinal surgery is important for rehabilitation and patient satisfaction. Wound infiltration with local anesthetics may improve postoperative pain, but true multimodal approaches for achieving analgesia after spinal surgery remain unknown. In this randomized, controlled, double-blind trial after lumbar interbody fusion, we asked: (1) Does multimodal analgesia reduce VAS pain scores by a clinically important amount? (2) Does this analgesic approach reduce the amount of morphine patients consume after surgery? (3) Is this approach associated with fewer opioid-related side effects after surgery? This study included 80 adult patients undergoing lumbar interbody fusion who were randomized into two groups: A control group (n = 40) who received infiltration of the surgical incision at the end of the procedure with an injection of 0.5% bupivacaine 100 mg (20 mL) and epinephrine 0.5 mg (0.5 mL), and the multimodal group (n = 40), who received wound infiltration with the same approach but with different medications: 0.5% bupivacaine 92.5 mg (18.5 mL), ketorolac 30 mg (1 mL), morphine 5 mg (0.5 mL), and epinephrine 0.5 mg (0.5 mL). There were no between-group differences in the proportion of patients wh...Continue Reading

References

Jun 15, 1993·Spine·D N BeamanV Chang
Sep 2, 2000·Anaesthesia and Intensive Care·E A Shipton
Jul 5, 2012·Journal of Neurosurgical Anesthesiology·Kadir OzyilmazIsil O Turan
Feb 12, 2013·Clinical Orthopaedics and Related Research·Nattapol TammachotePhonthakorn Panichkul
Aug 20, 2015·Journal of Craniovertebral Junction and Spine·Sukhminder Jit Singh Bajwa, Rudrashish Haldar
Mar 28, 2018·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·David L MurphyRichard C Dart
Mar 28, 2020·Pain Research & Management : the Journal of the Canadian Pain Society = Journal De La Société Canadienne Pour Le Traitement De La Douleur·Bao-Liang LiHai-Qiang Wang

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