Post Spinal Surgery Pain: Management Begins Before Your Approach

Background Data: Patients scheduled for spinal surgeries are expected to experience severe postoperative pain. Thus, effective postoperative analgesia is necessary to obtain an enhanced functional outcome, early ambulation, short hospital stay and prevention of chronic pain. Although opioid is the k...

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Autores principales:	Walid Abuzeid, Hytham Ali
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2015
Materias:	Post spinal surgery pain local infiltration VAS Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/fa337928844649bdae98ade550060096
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spelling	oai:doaj.org-article:fa337928844649bdae98ade5500600962021-12-02T04:47:32ZPost Spinal Surgery Pain: Management Begins Before Your ApproachDOI:10.21608/ESJ.2015.39792314-89502314-8969https://doaj.org/article/fa337928844649bdae98ade5500600962015-10-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_3979.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Patients scheduled for spinal surgeries are expected to experience severe postoperative pain. Thus, effective postoperative analgesia is necessary to obtain an enhanced functional outcome, early ambulation, short hospital stay and prevention of chronic pain. Although opioid is the key element of most postoperative analgesic regimens, multimodal therapy is currently an effective way to decrease opioid usage and the related adverse events. Pre-incision infiltration with local anesthetic is used to improve postoperative analgesia and reduce opioid consumption when given as a part of multimodal analgesia. Purpose: The purpose of this study was to prospectively evaluate the effectiveness of preemptive local infiltration with local anesthesia combined with systemic analgesia in pain control after spine surgery. Study Design: A prospective descriptive clinical case study. Patients and Methods: A prospective study of 147 cases of spine surgery operated at the neurosurgery department in Sohag university hospital from December 2011 to March 2015 was conducted. A basic monitoring was applied to all patients and anesthesia was induced according to the standard protocol following preemptive local infiltration with local anesthesia. Postoperative pain was controlled with paracetamol, ketorolac and/or nalbuphine. Postoperative pain was assessed using visual analogue score (VAS). Results: The study included 66 females and 81 male patients, aged 19-77 years. Discectomy was rated in spine surgeries followed by lumbar fixation, laminectomy, spinal cord tumors, lateral mass fixation and discectomy with cage. VAS didn’t exceed score 3 except for 9 cases rating (6%). They requested rescue analgesia. Most of the patients were allowed to move 3 hours after surgery except for those who revealed intraoperative dural injury (11 cases). Almost all patients were discharged to home after a short hospital stay less than 3 days. Only 9 cases stayed >3 days. Conclusion: Preemptive local infiltration with local anesthesia combined with systemic analgesia allowed good pain control after spine surgery, early ambulation, shortened the time of hospital stay and decreased the incidence of complications. (2015ESJ098)Walid AbuzeidHytham AliEgyptian Spine AssociationarticlePost spinal surgerypainlocal infiltrationVASNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 16, Iss 1, Pp 39-48 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Post spinal surgery pain local infiltration VAS Neurology. Diseases of the nervous system RC346-429
spellingShingle	Post spinal surgery pain local infiltration VAS Neurology. Diseases of the nervous system RC346-429 Walid Abuzeid Hytham Ali Post Spinal Surgery Pain: Management Begins Before Your Approach
description	Background Data: Patients scheduled for spinal surgeries are expected to experience severe postoperative pain. Thus, effective postoperative analgesia is necessary to obtain an enhanced functional outcome, early ambulation, short hospital stay and prevention of chronic pain. Although opioid is the key element of most postoperative analgesic regimens, multimodal therapy is currently an effective way to decrease opioid usage and the related adverse events. Pre-incision infiltration with local anesthetic is used to improve postoperative analgesia and reduce opioid consumption when given as a part of multimodal analgesia. Purpose: The purpose of this study was to prospectively evaluate the effectiveness of preemptive local infiltration with local anesthesia combined with systemic analgesia in pain control after spine surgery. Study Design: A prospective descriptive clinical case study. Patients and Methods: A prospective study of 147 cases of spine surgery operated at the neurosurgery department in Sohag university hospital from December 2011 to March 2015 was conducted. A basic monitoring was applied to all patients and anesthesia was induced according to the standard protocol following preemptive local infiltration with local anesthesia. Postoperative pain was controlled with paracetamol, ketorolac and/or nalbuphine. Postoperative pain was assessed using visual analogue score (VAS). Results: The study included 66 females and 81 male patients, aged 19-77 years. Discectomy was rated in spine surgeries followed by lumbar fixation, laminectomy, spinal cord tumors, lateral mass fixation and discectomy with cage. VAS didn’t exceed score 3 except for 9 cases rating (6%). They requested rescue analgesia. Most of the patients were allowed to move 3 hours after surgery except for those who revealed intraoperative dural injury (11 cases). Almost all patients were discharged to home after a short hospital stay less than 3 days. Only 9 cases stayed >3 days. Conclusion: Preemptive local infiltration with local anesthesia combined with systemic analgesia allowed good pain control after spine surgery, early ambulation, shortened the time of hospital stay and decreased the incidence of complications. (2015ESJ098)
format	article
author	Walid Abuzeid Hytham Ali
author_facet	Walid Abuzeid Hytham Ali
author_sort	Walid Abuzeid
title	Post Spinal Surgery Pain: Management Begins Before Your Approach
title_short	Post Spinal Surgery Pain: Management Begins Before Your Approach
title_full	Post Spinal Surgery Pain: Management Begins Before Your Approach
title_fullStr	Post Spinal Surgery Pain: Management Begins Before Your Approach
title_full_unstemmed	Post Spinal Surgery Pain: Management Begins Before Your Approach
title_sort	post spinal surgery pain: management begins before your approach
publisher	Egyptian Spine Association
publishDate	2015
url	https://doaj.org/article/fa337928844649bdae98ade550060096
work_keys_str_mv	AT walidabuzeid postspinalsurgerypainmanagementbeginsbeforeyourapproach AT hythamali postspinalsurgerypainmanagementbeginsbeforeyourapproach
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Post Spinal Surgery Pain: Management Begins Before Your Approach

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