• Si Young Park, Howard S An, Soon Hyuck Lee, Seung Woo Suh, Jeong Lae Kim, and Seung Joo Yoon.
• Department of Orthopaedic Surgery, Korea University, College of Medicine, Anam Hospital, 126-1 Anamdong 5ga, Seongbukgu, Seoul, Korea. drspine90@gmail.com.
• Eur Spine J. 2016 May 1; 25 (5): 1601-7.

PurposeTo assess the efficacy of continuous epidural infusion analgesia (ED) with 0.2 % Ropivacaine versus IV PCA (Fentanyl) in spinal fusion surgery patients.MethodA prospective randomized comparative clinical trial. Patients were randomized into one of two groups-the epidural group (ED-51 patients) and the IV PCA group (IV-43 patients). The epidural catheter tip was placed one level cephalad to the level of the PLIF in patients in the ED group. Patients were assessed by determining the pain score, cumulative opioid requirement, adverse effects, and satisfaction.ResultsPain score comparisons between the ED group and the IV group, respectively, were as follows: immediate postoperative status: 2.1 ± 1.5 vs. 7.2 ± 2.1, p = 0.01; postoperative day 1: 2.3 ± 1.9 vs. 6.8 ± 2.3, p = 0.02; postoperative day 2: 1.9 ± 1.8 vs. 5.4 ± 2.1, p = 0.02; postoperative day 3: 1.5 ± 1.6 vs. 3.9 ± 1.9, p = 0.03; postoperative day 4: 3.8 ± 2.1 vs. 3.1 ± 1.9, p = 0.4. Lower levels of opioids were required in the ED group, and fewer opioid-related complications developed in the patients in this group. Complications related to the use of epidural catheters were comparable between the two groups. Patient satisfaction with postoperative pain control was higher in the ED group.ConclusionIn comparison with the use of IV PCA only, continuous epidural infusion of Ropivacaine resulted in lower pain scores and opioid consumption and higher patient satisfaction levels after posterior lumbar interbody fusion.

4 keywords...

hide…