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논문 기본 정보

자료유형
학술저널
저자정보
Paweenus Rungwattanakit (Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand) Tarnkamon Sondtiruk (Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand) Akarin Nimmannit (Research Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand) Busara Sirivanasandha (Anesthesiology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.13 No.3
발행연도
2019.1
수록면
441 - 449 (9page)

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Study Design: A retrospective case-control study. Purpose: To evaluate the effect of nitrous oxide and anesthetic and operative factors associated with severe pain in the early postoperative period after thoracolumbar spine surgery. Overview of Literature: Thoracolumbar spine surgery is the most common procedure in spine surgery, and up to 50% of the patients suffer from moderate to severe pain. Nitrous oxide has analgesic, anxiolytic, and anesthetic effects; nevertheless, its benefits for early postoperative pain control and opioid consumption remain to be established. Methods: The medical records of eligible participants who underwent thoracolumbar spine surgery between July 2016 and February 2017 were reviewed. Enrolment was performed consecutively until reaching 90 patients for the case (severe pain) group (patients with a pain score of >7 out of 10 at least once during the post-anesthesia care unit [PACU] admission), and 90 patients for the control (mild-to-moderate pain) group (patients with a pain score of <7 in every PACU assessment). The data collected comprised patient factors, anesthetic factors, surgical factors, PACU pain score, and PACU pain management. Results: A total of 197 patients underwent thoracolumbar spine surgery with an incidence of early postoperative severe pain of 53.3%. The case-control study revealed no differences in the factors related to pain intensity. A subgroup analysis was performed for failed back surgery syndrome (FBSS), spinal stenosis, and spondylolisthesis. After multivariate analyses, only the age group of 19–65 years and the baseline Oswestry Disability Index (ODI) were found to be significant risk factors for early postoperative severe pain in the PACU (odds ratio [OR], 2.86; 95% confidence interval [CI], 1.32–6.25; OR, 1.03; 95% CI, 1.01–1.05, respectively). Conclusions: Nitrous oxide, anesthetic agents, and surgical techniques did not affect the early postoperative pain severity. Age under 66 years and the baseline ODI were the significant risk factors for pain intensity during the early postoperative period of the FBSS, spinal stenosis, and spondylolisthesis subgroups.
#Postoperative pain #Nitrous oxide #Spine surgery #Patient-controlled analgesia #Oswestry Disability Index #Post-anesthesia care unit

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참고문헌 (28)

참고문헌 신청
Thienthong S / 2004 / Treatment of pain after spinal surgery in the recovery room by single dose lornoxicam : a randomized, double blind, placebo-controlled trial / J Med Assoc Thai 87:650~655 google schola Nielsen RV / 2014 / Insufficient pain management after spine surgery / Dan Med J 61:A4835 google schola Gerbershagen HJ / 2013 / Pain intensity on the first day after surgery : a prospective cohort study comparing 179 surgical procedures / Anesthesiology 118:934~944 google schola Kim HJ / 2014 / Prediction of postoperative pain intensity after lumbar spinal surgery using pain sensitivity and preoperative back pain severity / Pain Med 15:2037~2045 google schola Wu MH / 2011 / A comparison of three types of postoperative pain control after posterior lumbar spinal surgery / Spine 36:2224~2231 google schola

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