Comparing the Effects between a Continuous Epidural Infusion of an Opioid or an Opioid-Local Anesthetic Mixture and a Continuous IV Infusion of an Opioid after a Spinal Laminectomy.

Sun,  Gum Tae; Lee,  Seung Yun; Kim,  Yun Soo; Lee,  Kyu Chang; Kang,  Po Soon; Lee,  Ye Chul

doi:2001.40.6.756

Clinical Research Article

Korean Journal of Anesthesiology 2001;40(6):756-762.
DOI: https://doi.org/10.4097/kjae.2001.40.6.756

Comparing the Effects between a Continuous Epidural Infusion of an Opioid or an Opioid-Local Anesthetic Mixture and a Continuous IV Infusion of an Opioid after a Spinal Laminectomy.

Gum Tae Sun, Seung Yun Lee, Yun Soo Kim, Kyu Chang Lee, Po Soon Kang, Ye Chul Lee

Department of Anesthesiology, College of Medicine, Kon-Kuk University, Choongju, and *Seoul, Korea.

Abstract

BACKGROUND
Postoperative pain after a spinal laminectomy has very harmful effects on human physiology, and many people are trying to control it more easily and safely. There are controversies in methods used for controlling postoperative pain after a spinal laminectomy. The purpose of this study was to examine an effective way to control postoperative pain after a spinal laminectomy.
METHODS
Ninety patients (ASA I-II, aged 40 to 70) scheduled for a spinal laminectomy were divided into three groups. In group A, we administered fentanyl 1,000 microgram and morphine 5 mg (mixed in 0.9% normal saline) using the continuous epidural infuser; in group B, we administered fentanyl 500 microgram and morphine 5 mg and 0.25% bupivacaine (mixed in 0.9% normal saline) using the continuous epidural infuser; in group C, we administered fentanyl 1,500 microgram and morphine 10 mg (mixed in 0.9% normal saline) using the continuous IV infuser. We compared effects between the continuous epidural infusion and the continuous intravenous infusion by using the visual analogue scale and side effects.
RESULTS
There was no significant difference between continuous epidural infusion groups. When the continuous epidural infusion groups and the continuous IV infusion group were compared, there were significant differences in 3 hr, 6 hr, and 12 hr VAS scores (P < 0.01). The incidence of side effects was very low, and there was no significant difference in side effects between the continuous epidural infusion and the continuous IV infusion groups.
CONCLUSIONS
It was found that continuous epidural infusion methods were more effective than the continuous IV infusion method, but none of them showed satisfactory postoperative pain control in the early periods.

Key Words: Analgesia: postoperative; Analgesics: epidural; fentanyl; intravenous; morphine; Anesthetics, local: bupivacaine; Surgery: spine