Immediate postoperative pain level from lumbar arthrodesis following epidural infiltration of morphine sulfate

Amaral, Carlos Alexandre Botelho do; Vieira, Tertuliano; Nakagawa, Edgar Taira; Losch, Eduardo Aires; Labronici, Pedro José

doi:10.1016/j.rboe.2015.02.005

Acessibilidade / Reportar erro

Brasil

Revista Brasileira de Ortopedia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Articles • Rev. bras. ortop. 50 (1) • Jan-Feb 2015 • https://doi.org/10.1016/j.rboe.2015.02.005 copy

Immediate postoperative pain level from lumbar arthrodesis following epidural infiltration of morphine sulfate ^☆ ☆ Work developed at the Prof. Dr. Donato D'Angelo Orthopedics and Traumatology Service, Hospital Santa Teresa, and in the Petr6polis School of Medicine, Petr6polis, RJ, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

To evaluate the pain level in patients treated with epidural infusion of morphine sulfate in a single dose, after a surgical procedure to perform lumber arthrodesis.

METHODS:

Forty patients underwent posterolateral lumbar arthrodesis or intersomatic lumbar arthrodesis via a posterior route at one, two or three levels. They were prospectively randomized into two groups of 20. In the first group (study group), 2 mg of morphine sulfate diluted in 10 mL of physiological serum was infiltrated into the epidural space, through the laminectomy area. The second group (controls) did not receive analgesia. The patients were asked about their pain levels before and after the operation, using a visual analog scale (VAS).

RESULTS:

It was found that the patients presented a significant diminution of pain as shown by the VAS. From before to after the operation, it decreased by an average of 4.7 points (p = 0.0001), which corresponded to 53.2% (p = 0.0001).

CONCLUSION:

Application of 2 mg of morphine sulfate in a single epidural dose was shown to be a good technique for pain therapy following lumbar spinal surgery.

Morphine; Epidural analgesia; Postoperative pain; Arthrodesis; Vertebral fusion

Variable	Study group (n = 20)	Control group (n = 20)
Female sex, n (%)	12 (60.0%)	11 (55.0%)
Male sex, n (%)	8 (40.0%)	9 (45.0%)
Disk hernia, n (%)	10 (50.0%)	11 (55.0%)
Vertebral canal stenosis, n (%)	10 (50.0%)	9 (45%)
Age (years)	52.1 ± 11.2	51.1 ± 13.7

Variable	Study (n = 20)	Control (n = 20)	p Value ^a
Female sex, n (%)	12 (60%)	11 (55%)	0.74
Pathological condition of disk hernia, n (%)	10 (50%)	11 (55%)	0.75
Age (years)	52.1 ± 11.2	51.1 ± 13.7	0.79

Variable	Mean	SD	Median	p Value ^a
Preoperative pain scale (points)	8.8	0.9	9
Postoperative pain scale (points)	4.1	1.4	4
Absolute delta (points)	-4.7	1.6	-4	0.0001
Relative delta (%)	-53.2	15.6	-50.0	0.0001

Variable	Mean	SD	Median	p Value ^a
Preoperative pain scale (points)	9.3	0.7	9
Postoperative pain scale (points)	6.6	1.2	7
Absolute delta (points)	-2.7	0.9	-2.8	0.0001
Relative delta (%)	-28.8	9.7	-29.7	0.0001

Variable	Study (n = 20)		Control (n = 20)		p Value ^a
	Mean ± SD	Median	Mean ± SD	Median
Preoperative pain scale (points)	8.8 ± 0.9	9	9.3 ± 0.7	9	0.086
Postoperative pain scale (points)	4.1 ± 1.4	4	6.6 ± 1.2	7	0.0001
Absolute delta (points)	-4.7 ± 1.6	-4.0	-2.7 ± 0.90	-2.8	0.0001
Relative delta (%)	-53.2 ± 15.6	-50	-28.8 ± 9.7	-29.7	0.0001

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] * Corresponding author. E-mail: carlosaba@oi.com.br (C.A.B. Amaral).

Brasil

Brasil

Immediate postoperative pain level from lumbar arthrodesis following epidural infiltration of morphine sulfate ☆ ☆ Work developed at the Prof. Dr. Donato D'Angelo Orthopedics and Traumatology Service, Hospital Santa Teresa, and in the Petr6polis School of Medicine, Petr6polis, RJ, Brazil.

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Immediate postoperative pain level from lumbar arthrodesis following epidural infiltration of morphine sulfate ^☆ ☆ Work developed at the Prof. Dr. Donato D'Angelo Orthopedics and Traumatology Service, Hospital Santa Teresa, and in the Petr6polis School of Medicine, Petr6polis, RJ, Brazil.