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KMID : 0356920070520030296
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Korean Journal of Anesthesiology
2007 Volume.52 No. 3 p.296 ~ p.300
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The Effect of Preoperative Epidural Analgesia with Intravenous Patient-controlled Analgesia (IV-PCA) for Postoperative Pain Control in Bone Fusion and Pedicle Screw Fixation
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Shim Kyu-Dae
Lee Sang-Ho
Hwang Kyung-Il
Kim Kwang-Hee
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Abstract
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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.
Conclusion: 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.
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KEYWORD
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epidural analgesia, intravenous patient-controlled analgesia, morphine, ropivacaine
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