Is preemptive analgesia a good choice for postoperative pain relief in lumbar spine surgeries?

Abstract

Background: Lumbar spine surgery is associated with moderate-to-severe postoperative pain. Adequate pain management during the postoperative period facilitates rehabilitation. Recently, preemptive analgesia has been considered among the important analgesic methods for reducing postoperative pain. However, its efficacy in postoperative pain relief after lumbar spine surgery remains unclear. This study aimed to evaluate the effects of preemptive analgesia on lumbar spine surgery. Methods: We searched for randomized controlled trials in PubMed (1996 to May 2020), Embase (1980 to May 2020), and Cochrane Library (CENTRAL, May 2020). We included seven studies that evaluated the preemptive analgesic efficacy in lumbar spine surgeries. Results: Seven studies, including 509 patients, met the inclusion criteria. Pooled data revealed that preemptive analgesia is effective for lumbar spine surgeries with respect to the visual analog scale score ( P < .05), total morphine equivalent consumption ( P < .05), and length of stay ( P < .05), without increasing complications ( P = .73). Conclusions: Our findings indicate that preemptive analgesia is safe and effective for lumbar spine surgery.

Postoperative pain relief and functional outcomes after pre-emptive ultrasound-guided caudal analgesia in patients undergoing spinal laminectomy under general anaesthesia: Comparison between bupivacaine versus bupivacaine with morphine

“…Eighty percent of the patients suffering from chronic backache undergo discectomy for pain relief, yet 86% of these patients experience moderate to severe postoperative pain. [ 10 ] Inadequate pain management after spine surgery can lead to patient dissatisfaction and delayed functional recovery, whereas optimal postoperative pain management leads to early ambulation, reduced length of hospital stay and better long-term functional outcomes. [ 10 ]…”

“…[ 10 ] Inadequate pain management after spine surgery can lead to patient dissatisfaction and delayed functional recovery, whereas optimal postoperative pain management leads to early ambulation, reduced length of hospital stay and better long-term functional outcomes. [ 10 ]…”

Postoperative Analgesia

“…The effective preemptive analgesic technique requires a multimodal approach of nociceptive input, increasing the threshold for nociception and decreasing nociceptor receptor activation. Primitive analgesics are safe and effective and have superior pain control with a decreased VAS score of pain [27].…”

Application of sequential multimodal analgesia before and after impacted mandibular third molar extraction: Protocol for a randomized controlled trial

“…In particular, it is essential to reduce the secretion of the inflammatory chemical mediators secreted due to peripheral tissue damage and block the mechanism by which pain signals are transmitted to the ascending neurons [ 15 , 16 ]. While the usefulness of preemptive analgesic therapy has been widely established in various surgical fields, including chest, abdominal, and orthopedic fields, there have been conflicting reports on its effectiveness in the maxillofacial area [ [16] , [17] , [18] , [19] ]. Several prospective, randomized, and double-blind studies have evaluated the effectiveness of preemptive analgesic administration versus conventional analgesic therapy during the surgical extraction of iMnM3 with inconsistent conclusions.…”