Korean J Anesthesiol.  2007 Mar;52(3):296-300. 10.4097/kjae.2007.52.3.296.

The Effect of Preoperative Epidural Analgesia with Intravenous Patient-controlled Analgesia (IV-PCA) for Postoperative Pain Control in Bone Fusion and Pedicle Screw Fixation

• Shim KD
• Lee SH
• Hwang KI
• Kim KH

• KMID: 1937593
• DOI: http://doi.org/10.4097/kjae.2007.52.3.296

Abstract

BACKGROUND
Postoperative pain control following bone fusion and pedicle screw fixation is insufficient with IV-PCA alone. Therefore, the effect of preoperative epidural analgesia in addition to IV-PCA was evaluated for postoperative pain control following bone fusion and pedicle screw fixation surgery.
METHODS
Eighty patients, scheduled to undergo bone fusion and pedicle screw fixation, were randomly assigned to two groups; the study (n = 40) or control groups (n = 40). After induction, the patient was turned into the prone position, and morphine 2 mg and 10 ml of 0.2% ropivacaine were injected into the L1/2 epidural space, after dye confirmation, under C-arm guidance for the study group, with 10 ml normal saline injected into the L1/2 epidural space for the control group. After induction, IV-PCA was applied in both groups. After the operation, the NRS (numerical rating scale) and side effects were evaluated immediately post-op, and at 24 and 48 hours after the operation.
RESULTS
In the study group, the NRS was more reduced for all periods compared with the control group, but the incidences of nausea/vomiting and pruritus were no different from the control group.
CONCLUSIONS
It was concluded that preoperative epidural analgesia, in addition to IV-PCA, was a good postoperative pain control method following bone fusion and pedicle screw fixation.

Keyword

epidural analgesia; intravenous patient-controlled analgesia; morphine; ropivacaine

MeSH Terms

Analgesia, Epidural*
Analgesia, Patient-Controlled*
Epidural Space
Humans
Incidence
Morphine
Pain, Postoperative*
Prone Position
Pruritus
Morphine