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RETROSPECTIVE STUDY OF THE EFFECTS OF AN EPIDURAL BLOCK ON POSTOPERATIVE PAIN IN CERVICAL SPINE SURGERY
Author(s):
Nishiyama , T.*
Affiliations:
Saitama, Japan
ESRA Academy. Nishiyama T. Sep 13, 2017; 190951; 09 Topic: Back surgery
Disclosure(s): none
Dr. Tomoki Nishiyama
Dr. Tomoki Nishiyama

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Abstract
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Background and Aims:

For postoperative analgesia in cervical spine surgery, intravenous or suppository analgesics are usually used. In this retrospective study, we evaluated the effects of preoperative epidural block on postoperative pain in cervical laminoplasty.

Methods:

Thirty two patients with standard care (control group) and 34 patients who received preoperative epidural block (epidural group) aged 40 to 80 with ASA I or II in cervical laminoplasty were retrospectively enrolled. We have standard perioperative protocol in spinal surgery. All patients gave informed consent for presentation with the consent of anesthesia, and the protocol was approved by the ethics committee. Anesthesia was induced with midazolam, propofol, fentanyl and vecuronium, and maintained with desflurane and remifentanil. At the end of surgery, all patients received acetaminophen 1000 mg and flurbiprofen 50 mg. In the epidural group, an epidural block with 1% lidocaine 2mL, 1% ropivacaine 1mL with saline 3mL was performed at C6/7 before surgery. Postoperative rescue analgesia was 1. intravenous flurbiprofen, 2. diclofenac suppository, and 3. intravenous pentazocine with 1hour interval when pain was rated as more than 5 in 10 scale (VAS score). VAS score, number of postoperative rescue analgesia, nausea, vomit, and headache, and vital signs in postoperative 24 hours were compared between the groups.

Results:

Vital signs, number of nausea, vomit, and headache were not different among the groups. VAS score and number of rescue analgesia were significantly lower in the epidural block.

Conclusions:

Preoperative epidural block was useful for postoperative analgesia in cervical laminoplasty.

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