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Korean J Anesthesiol > Volume 52(3); 2007 > Article
Korean Journal of Anesthesiology 2007;52(3):296-300.
DOI: https://doi.org/10.4097/kjae.2007.52.3.296   
The Effect of Preoperative Epidural Analgesia with Intravenous Patient-controlled Analgesia (IV-PCA) for Postoperative Pain Control in Bone Fusion and Pedicle Screw Fixation.
Kyu Dae Shim, Sang Ho Lee, Kyung Il Hwang, Kwang Hee Kim
Departments of Anesthesiology and Pain Medicine and *Neurosurgery, Wooridul Spine Hospital, Seoul, Korea. skdphd@naver.com
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.
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.
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.
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.
Key Words: epidural analgesia; intravenous patient-controlled analgesia; morphine; ropivacaine
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