Insufficient pain management after spine surgery.

Autor: Nielsen RV; Anæstesiologisk Afdeling, Glostrup Hospital, Nordre Ringvej 57, 2600 Glostrup, Denmark. rikkesoennichsen@gmail.com., Fomsgaard JS, Dahl JB, Mathiesen O
Jazyk: angličtina
Zdroj: Danish medical journal [Dan Med J] 2014 May; Vol. 61 (5), pp. A4835.
Abstrakt: Introduction: A prospective observational quality assurance study was performed at Glostrup Hospital, Denmark, to describe patients undergoing spine surgery with regard to perioperative analgesic management, post-operative pain, opioid consumption and side effects.
Material and Methods: Patients eligible for the study were identified consecutively from the operation chart. The following data were registered: post-operative visual analogue (VAS) pain score at rest and during mobilisation, opioid consumption for the first 24 h, other analgesics administered and side effects.
Results: A total of 87 patients were included. For instrumented lumbar fusion patients (n = 24), the VAS pain scores at 1, 4 and 24 h after surgery were (median (interquartile range)) 5 (0-7), 2.5 (0-8) and 5.5 (0-9) at rest and 5 (0-8), 3 (0-9) and 7 (3-9) during mobilisation, respectively. The other surgical subgroups generally experienced VAS ≤ 3. For instrumented lumbar fusion, the total 0-24 h consumption of intravenous morphine equivalents was 39.1 (27.5-62.7) mg. Only eight of 87 patients received the entire scheduled standard post-operative pain treatment. Adverse events were rare.
Conclusion: Most patients experienced acceptable pain levels, but instrumented lumbar fusion leads to moderate to severe pain levels and a relatively high opioid consumption. The scheduled standard pain management protocols were sparsely followed. Challenges exist in post-operative pain management as observed in previous surveys, especially for instrumented lumbar fusion surgery. Future work should focus on optimising treatment plans.
Funding: not relevant.
Trial Registration: not relevant.
Databáze: MEDLINE
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