Pain physician
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Randomized Controlled Trial
The Efficacy of Erector Spinae Plane Block Compared With Intrathecal Morphine in Postoperative Analgesia in Patients Undergoing Lumbar Spine Surgery: A Double-blind Prospective Comparative Study.
Severe postoperative pain is experienced by most patients who undergo spine surgery. Erector spinae plane block (ESPB) is a successful method for postoperative analgesia and has only minor complications. Intrathecal morphine (ITM) demonstrates high efficacy for analgesia up to 24 hours postsurgery. ESPBs and ITM for postoperative analgesia in lumbar spine surgeries have never been compared in prior studies. ⋯ We concluded that ITM 0.3 mg provides more potent analgesia up to 48 hours postoperatively than an ESPB, based upon VAS score, analgesic durations, and postoperative analgesic requirements.
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Poorly managed chronic spinal pain encumbers medical resources and drives healthcare costs, suggesting a target for improvement. ⋯ We observed meaningful savings in cost and resource use when chronic spine-pain patients were managed by pain specialists. Pain-management referrals should be an element of a thoughtfully designed care pathway.