A prospective randomized comparative study of postoperative pain control using an epidural catheter in patients undergoing posterior lumbar interbody fusion

Si Young Park, Howard S. An, Soon-Hyuck Lee, Seung-Woo Suh, Jeong Lae Kim, Seung Joo Yoon

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: To assess the efficacy of continuous epidural infusion analgesia (ED) with 0.2 % Ropivacaine versus IV PCA (Fentanyl) in spinal fusion surgery patients. Method: A prospective randomized comparative clinical trial. Patients were randomized into one of two groups—the epidural group (ED-51 patients) and the IV PCA group (IV-43 patients). The epidural catheter tip was placed one level cephalad to the level of the PLIF in patients in the ED group. Patients were assessed by determining the pain score, cumulative opioid requirement, adverse effects, and satisfaction. Results: Pain score comparisons between the ED group and the IV group, respectively, were as follows: immediate postoperative status: 2.1 ± 1.5 vs. 7.2 ± 2.1, p = 0.01; postoperative day 1: 2.3 ± 1.9 vs. 6.8 ± 2.3, p = 0.02; postoperative day 2: 1.9 ± 1.8 vs. 5.4 ± 2.1, p = 0.02; postoperative day 3: 1.5 ± 1.6 vs. 3.9 ± 1.9, p = 0.03; postoperative day 4: 3.8 ± 2.1 vs. 3.1 ± 1.9, p = 0.4. Lower levels of opioids were required in the ED group, and fewer opioid-related complications developed in the patients in this group. Complications related to the use of epidural catheters were comparable between the two groups. Patient satisfaction with postoperative pain control was higher in the ED group. Conclusion: In comparison with the use of IV PCA only, continuous epidural infusion of Ropivacaine resulted in lower pain scores and opioid consumption and higher patient satisfaction levels after posterior lumbar interbody fusion.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalEuropean Spine Journal
DOIs
Publication statusAccepted/In press - 2016 Jan 19

Fingerprint

Postoperative Pain
Catheters
Opioid Analgesics
Passive Cutaneous Anaphylaxis
Patient Satisfaction
Pain
Spinal Fusion
Epidural Analgesia
Fentanyl
Randomized Controlled Trials

Keywords

  • Epidural catheter
  • IV PCA
  • Posterior lumbar interbody fusion
  • Postoperative pain
  • Ropivacaine

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{f1a9043ef4874a9a985cd37784c7ac4b,
title = "A prospective randomized comparative study of postoperative pain control using an epidural catheter in patients undergoing posterior lumbar interbody fusion",
abstract = "Purpose: To assess the efficacy of continuous epidural infusion analgesia (ED) with 0.2 {\%} Ropivacaine versus IV PCA (Fentanyl) in spinal fusion surgery patients. Method: A prospective randomized comparative clinical trial. Patients were randomized into one of two groups—the epidural group (ED-51 patients) and the IV PCA group (IV-43 patients). The epidural catheter tip was placed one level cephalad to the level of the PLIF in patients in the ED group. Patients were assessed by determining the pain score, cumulative opioid requirement, adverse effects, and satisfaction. Results: Pain score comparisons between the ED group and the IV group, respectively, were as follows: immediate postoperative status: 2.1 ± 1.5 vs. 7.2 ± 2.1, p = 0.01; postoperative day 1: 2.3 ± 1.9 vs. 6.8 ± 2.3, p = 0.02; postoperative day 2: 1.9 ± 1.8 vs. 5.4 ± 2.1, p = 0.02; postoperative day 3: 1.5 ± 1.6 vs. 3.9 ± 1.9, p = 0.03; postoperative day 4: 3.8 ± 2.1 vs. 3.1 ± 1.9, p = 0.4. Lower levels of opioids were required in the ED group, and fewer opioid-related complications developed in the patients in this group. Complications related to the use of epidural catheters were comparable between the two groups. Patient satisfaction with postoperative pain control was higher in the ED group. Conclusion: In comparison with the use of IV PCA only, continuous epidural infusion of Ropivacaine resulted in lower pain scores and opioid consumption and higher patient satisfaction levels after posterior lumbar interbody fusion.",
keywords = "Epidural catheter, IV PCA, Posterior lumbar interbody fusion, Postoperative pain, Ropivacaine",
author = "Park, {Si Young} and An, {Howard S.} and Soon-Hyuck Lee and Seung-Woo Suh and Kim, {Jeong Lae} and Yoon, {Seung Joo}",
year = "2016",
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doi = "10.1007/s00586-016-4385-8",
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T1 - A prospective randomized comparative study of postoperative pain control using an epidural catheter in patients undergoing posterior lumbar interbody fusion

AU - Park, Si Young

AU - An, Howard S.

AU - Lee, Soon-Hyuck

AU - Suh, Seung-Woo

AU - Kim, Jeong Lae

AU - Yoon, Seung Joo

PY - 2016/1/19

Y1 - 2016/1/19

N2 - Purpose: To assess the efficacy of continuous epidural infusion analgesia (ED) with 0.2 % Ropivacaine versus IV PCA (Fentanyl) in spinal fusion surgery patients. Method: A prospective randomized comparative clinical trial. Patients were randomized into one of two groups—the epidural group (ED-51 patients) and the IV PCA group (IV-43 patients). The epidural catheter tip was placed one level cephalad to the level of the PLIF in patients in the ED group. Patients were assessed by determining the pain score, cumulative opioid requirement, adverse effects, and satisfaction. Results: Pain score comparisons between the ED group and the IV group, respectively, were as follows: immediate postoperative status: 2.1 ± 1.5 vs. 7.2 ± 2.1, p = 0.01; postoperative day 1: 2.3 ± 1.9 vs. 6.8 ± 2.3, p = 0.02; postoperative day 2: 1.9 ± 1.8 vs. 5.4 ± 2.1, p = 0.02; postoperative day 3: 1.5 ± 1.6 vs. 3.9 ± 1.9, p = 0.03; postoperative day 4: 3.8 ± 2.1 vs. 3.1 ± 1.9, p = 0.4. Lower levels of opioids were required in the ED group, and fewer opioid-related complications developed in the patients in this group. Complications related to the use of epidural catheters were comparable between the two groups. Patient satisfaction with postoperative pain control was higher in the ED group. Conclusion: In comparison with the use of IV PCA only, continuous epidural infusion of Ropivacaine resulted in lower pain scores and opioid consumption and higher patient satisfaction levels after posterior lumbar interbody fusion.

AB - Purpose: To assess the efficacy of continuous epidural infusion analgesia (ED) with 0.2 % Ropivacaine versus IV PCA (Fentanyl) in spinal fusion surgery patients. Method: A prospective randomized comparative clinical trial. Patients were randomized into one of two groups—the epidural group (ED-51 patients) and the IV PCA group (IV-43 patients). The epidural catheter tip was placed one level cephalad to the level of the PLIF in patients in the ED group. Patients were assessed by determining the pain score, cumulative opioid requirement, adverse effects, and satisfaction. Results: Pain score comparisons between the ED group and the IV group, respectively, were as follows: immediate postoperative status: 2.1 ± 1.5 vs. 7.2 ± 2.1, p = 0.01; postoperative day 1: 2.3 ± 1.9 vs. 6.8 ± 2.3, p = 0.02; postoperative day 2: 1.9 ± 1.8 vs. 5.4 ± 2.1, p = 0.02; postoperative day 3: 1.5 ± 1.6 vs. 3.9 ± 1.9, p = 0.03; postoperative day 4: 3.8 ± 2.1 vs. 3.1 ± 1.9, p = 0.4. Lower levels of opioids were required in the ED group, and fewer opioid-related complications developed in the patients in this group. Complications related to the use of epidural catheters were comparable between the two groups. Patient satisfaction with postoperative pain control was higher in the ED group. Conclusion: In comparison with the use of IV PCA only, continuous epidural infusion of Ropivacaine resulted in lower pain scores and opioid consumption and higher patient satisfaction levels after posterior lumbar interbody fusion.

KW - Epidural catheter

KW - IV PCA

KW - Posterior lumbar interbody fusion

KW - Postoperative pain

KW - Ropivacaine

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