Postoperative Schmerztherapie mittels PDK nach instrumentierten Wirbelsäulenoperationen - ein Erfahrungsbericht

K, Eilers; Putzier, Michael; Volk, Thomas; Wj, Kox; Zippel, H

doi:10.1055/s-2002-36043

Cited by 9 publications

(6 citation statements)

References 7 publications

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“…The average cumulative dose of rescue opioids was 1.2 (0–4mg) in group 1 versus 0.4mg (0–2) in group 2 ( p = 0.071). The average times between surgery and the first rescue dose were 3.25 (2–7) versus 4.3 hours 2 3 4 5 6 for groups 1 and 2, respectively ( p = 0.56; Table 2 ).…”

Section: Resultsmentioning

confidence: 98%

“…The average cumulative rescue dose used in group 1 was 3.2mg (1–6mg). The average time between surgery and the first rescue dose in group 1 was 3.25 hours 2 3 4 5 6 7 ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Nonetheless, pain management after spine surgery has largely only been reported in the literature for fixation procedures and, as can be expected, both pain and pain relief depend on the type and extensiveness of the surgery. [1][2][3][4][5][6] It is well documented that effective pain management decreases patients' morbidity after surgery by minimizing the stress response to trauma tissue. Patients are able to recover more quickly and thereby have a shorter length of hospital stay.…”

Section: Introductionmentioning

confidence: 99%

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Bilateral Radioscopically Guided Erector Spinae Plane Block for Postoperative Analgesia in Spine Surgery: A Randomized Clinical Trial

Beltrame

Fasano

Jalón

2022

J Neurol Surg A Cent Eur Neurosurg

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Study design: Randomized clinical trial. Objectives: To compare two perioperative pain management procedures: a radioscopically-guided erector spinae plane (ESP) block versus the standard wound infiltration technique with local anaesthetics, in patients undergoing lumbosacral spine surgery. Methods: A randomized, double-blind clinical trial was performed, in which adults at our hospital undergoing lumbosacral surgery without fixation were randomly assigned to receive either the standard wound infiltration technique, employing long-term anaesthetics, or a radioscopically-guided ESP block. Postoperative pain severity, morphine consumption, number of patients immobilised due to wound pain, length of hospitalisation, and complications were recorded. Results: Over the first seven postoperative hours, pain relief was superior in the ESP block group among patients who underwent discectomies or one-level decompression (p<0.0001). Using an ESP block also was statistically superior at decreasing all postoperative variables recorded in patients scheduled for multi-level decompression: VAS pain severity over the first seven hours after the procedure (p=0,0004); number of patients with wound pain 1 (p=0.049), 7 (p<0.0001) and 24 hours (p=0.007) after surgery; length of hospitalisation (p=0.0007), number of patients immobilised for wound pain (p=0.0004) and rescue morphine consumption (p<0.0001). Conclusion: The ESP block is a safe procedure which seems to outperform the infiltration wound technique for postoperative pain management in patients undergoing open spinal surgery. Future studies are needed to verify its effectiveness for arthrodesis/fixation and minimally-invasive procedures, and for chronic spine pain relief. Keywords: erector muscles - spinal surgery - postoperative analgesia -nerve block

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Section: Resultsmentioning

confidence: 98%

“…The average cumulative rescue dose used in group 1 was 3.2mg (1–6mg). The average time between surgery and the first rescue dose in group 1 was 3.25 hours 2 3 4 5 6 7 ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Bilateral Radioscopically Guided Erector Spinae Plane Block for Postoperative Analgesia in Spine Surgery: A Randomized Clinical Trial

Beltrame

Fasano

Jalón

2022

J Neurol Surg A Cent Eur Neurosurg

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“…1,3,8,11,12 Since we had already observed sensory and motor impairment, we are sure we did not underdose EDA in our patients. However, there may be another more effective regimen.…”

Section: Discussionmentioning

confidence: 70%

Efficacy of post-operative analgesia after posterior lumbar instrumented fusion for degenerative disc disease: a prospective randomized comparison of epidural catheter and intravenous administration of analgesics

Kluba

Hofmann²,

Bredanger³

et al. 2010

Orthop Rev

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This prospective study aimed to compare the efficacy of epidural (EDA) versus intravenous (PCA) application of analgesics after lumbar fusion. Fifty-two patients scheduled for elective posterior instrumented lumbar fusion were randomized into two groups. EDA patients received an epidural catheter intraoperatively, and administration of ropivacain and sulfentanil was started after a normal postoperative wake-up test in the recovery room area. PCA patients received intravenous opioids in the post-operative period. Differences between EDA and PCA groups in terms of patient satisfaction with respect to pain relief were not significant. Nevertheless, EDA patients reported less pain on the third day after surgery. There were significantly more side effects in the EDA group, including complete reversible loss of sensory function and motor weakness. There were no major side effects, such as infection or persisting neurological deficits, in either group. The routine use of epidural anesthesia for lumbar spine surgery has too many risks and offers very little advantage over PCA.

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Prä- und postoperative Fast-track-Behandlungskonzepte in der Wirbelsäulenchirurgie

et al. 2014

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The hospital stay was reduced from 10.9 to 6.2 days after introduction of a multimodal patient school that was held 10 days prior to admission, with mobilization on the day of surgery with a strictly followed treatment plan supervised by therapists and taking into account the patient's own assessment, as well an early plan for discharge based on fixed established criteria. This concept is a very successful tool to achieve high quality standard of treatment paired with a reduction of hospital stay.

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Postoperative Schmerztherapie mittels PDK nach instrumentierten Wirbelsäulenoperationen - ein Erfahrungsbericht

Cited by 9 publications

References 7 publications

Bilateral Radioscopically Guided Erector Spinae Plane Block for Postoperative Analgesia in Spine Surgery: A Randomized Clinical Trial

Bilateral Radioscopically Guided Erector Spinae Plane Block for Postoperative Analgesia in Spine Surgery: A Randomized Clinical Trial

Efficacy of post-operative analgesia after posterior lumbar instrumented fusion for degenerative disc disease: a prospective randomized comparison of epidural catheter and intravenous administration of analgesics

Prä- und postoperative Fast-track-Behandlungskonzepte in der Wirbelsäulenchirurgie

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