Postoperative patient-controlled epidural analgesia in patients with spondylodiscitis and posterior spinal fusion surgery

Geßler, Florian; Mutlak, Haitham; Tizi, Karima; Senft, Christian; Setzer, Matthias; Seifert, Volker; Weise, Lutz

doi:10.3171/2015.8.spine15415

Cited by 25 publications

(23 citation statements)

References 21 publications

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“…As the obvious pain after lumbar surgery, postoperative analgesia is often needed. However, patient-controlled intravenous analgesia and epidural analgesia, which are commonly used in clinic, have their own shortcomings [4,24]. Side effects such as nausea and vomiting caused by postoperative opioid use result in poor postoperative experience, reduce patient satisfaction, and are not conducive to rapid recovery [25].…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of the erector spinae plane block in lumbar spinal surgery patients: a systematic review

Qiu¹,

Zhang²,

Meng³

et al. 2019

Preprint

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Background: Erector spinae palne block (ESPB) as a new trunk fascia block technique was proposed in 2016. Because of its clear analgesic effect and simple operation, it has aroused the interest of many nerve block experts. However, there are few clinical studies on ESPB for lumbar surgery, and its benefits are controversial. The goal of this review paper is to summarize the use of ESPB for lumbar spine surgery in order to better understand and promote this technique.Methods: Pubmed, EMBASE, Cochrane library, ClinicalTrial.gov databases were searched up to July 30, 2019. According to the inclusion and exclusion criteria established in advance, “lumbar spine surgery” and “ESPB” related MesH terms, free-text words were used. Data on pain scores, analgesic consumptions and adverse effects were reported. All processes follow PRISMA statement guidelines.Results: A total of 171 participants from 11 publications were identified, including two randomized controlled trials, one retrospective cohort study, four case report, four cases series. Block operation plane from T8 to L4. The main anesthetics used in block are bupivacaine, ropivacaine and lidocaine. There was evidence for reducing postoperative pain scores and analgesic consumptions.Conclusion: ESPB in lumbar spine surgery have the potential to relieve lumbar postoperative pain and reduce the use of analgesic drugs. Randomized controlled trials of high quality and large samples are needed to further clarify the benefits of ESPB in lumbar surgery patients.

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Section: Discussionmentioning

confidence: 99%

“…However, patientcontrolled analgesia is prone to opioid-related side effects. Epidural injection is associated with infections, hematomas and other adverse events [3,4]. Furthermore, the analgesic effect of conventional postoperative analgesia is limited.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of the erector spinae plane block in lumbar spinal surgery patients: a systematic review

Qiu¹,

Zhang²,

Meng³

et al. 2019

Preprint

View full text Add to dashboard Cite

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“…Epidural injection is associated with infections, hematomas and other adverse events. 3,4 Furthermore, the analgesic effect of conventional postoperative analgesia is limited. If the postoperative pain of the lumbar spine could not be effectively relieved, it may develop into chronic pain, affecting the quality of life of the patients.…”

Section: Introductionmentioning

confidence: 99%

<p>Erector Spinae Plane Block for Lumbar Spinal Surgery: A Systematic Review</p>

Qiu

Zhang

Hua

2020

JPR

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Background: Erector spinae plane block (ESPB) as a new trunk fascia block technique was proposed in 2016. ESPB has aroused the interest of many nerve block experts. However, there are few clinical studies on ESPB for lumbar surgery, and its effectiveness and safety are controversial. The goal of this review is to summarize the use of ESPB for lumbar spine surgery in order to better understand this technique. Methods: PubMed, EMBASE, Cochrane library and ClinicalTrial.gov databases were searched up to July 30, 2019. According to the inclusion and exclusion criteria established in advance, "lumbar spine surgery" and "ESPB" related MesH terms and free-text words were used. Data on pain scores, analgesic consumptions and adverse effects were reported. All processes follow PRISMA statement guidelines. Results: A total of 171 participants from 11 publications were identified, including two randomized controlled trials (RCTs), one retrospective cohort study, four case reports and four cases series. Block operation planes from T8 to L4. The main anesthetics used in the block are bupivacaine, ropivacaine and lidocaine. There was evidence for reducing postoperative pain scores and analgesic consumptions. Conclusion: The effectiveness and safety of ESPB for lumbar spine surgery are still controversial. The current evidence is insufficient to support the widespread use of ESPB for lumbar spine surgery. High-quality RCTs are urgently needed.

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“…Instrumentation of the spine included dorsal, ventral or combined approaches. Postoperative pain management was carried out as published before 14) . QOL was evaluated prospectively with the Short-Form Health Survey 36 (SF-36) questionnaire.…”

Section: Methodsmentioning

confidence: 99%

Early versus Delayed Surgery for Spinal Epidural Abscess : Clinical Outcome and Health-Related Quality of Life

Behmanesh

Geßler

Quick-Weller

et al. 2020

J Korean Neurosurg Soc

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Objective : Spinal epidural abscess (SEA) is a severe and life-threatening disease. Although commonly performed, the effect of timing in surgical treatment on patient outcome is still unclear. With this study, we aim to provide evidence for early surgical treatment in patients with SEA. Methods : Patients treated for SEA in the authors' department between 2007 and 2016 were included for analysis and retrospectively analyzed for basic clinical parameters and outcome. Pre-and postoperative neurological status were assessed using the American Spinal Injury Association Impairment Scale (AIS). The self-reported quality of life (QOL) based on the Short-Form Health Survey 36 (SF-36) was assessed prospectively. Surgery was defined as "early", when performed within 12 hours after admission and "late" when performed thereafter. Conservative therapy was preferred and recommend in patients without neurological deficits and in patients denying surgical intervention. Results : One hundred and twenty-three patients were included in this study. Forty-nine patients (39.8%) underwent early, 47 patients (38.2%) delayed surgery and 27 (21.9%) conservative therapy. No significant differences were observed regarding mean age, sex, diabetes, prior history of spinal infection, and bony destruction. Patients undergoing early surgery revealed a significant better clinical outcome before discharge than patients undergoing late surgery (p=0.001) and conservative therapy. QOL based on SF-36 were significantly better in the early surgery cohort in two of four physical items (physical functioning and bodily pain) and in one of four psychological items (role limitation) after a mean follow-up period of 58 months. Readmission to the hospital and failure of conservative therapy were observed more often in patients undergoing conservative therapy. Conclusion : Our data on both clinical outcome and QOL provide evidence for early surgery within 12 hours after admission in patients with SEA.

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Postoperative patient-controlled epidural analgesia in patients with spondylodiscitis and posterior spinal fusion surgery

Cited by 25 publications

References 21 publications

Efficacy of the erector spinae plane block in lumbar spinal surgery patients: a systematic review

Efficacy of the erector spinae plane block in lumbar spinal surgery patients: a systematic review

<p>Erector Spinae Plane Block for Lumbar Spinal Surgery: A Systematic Review</p>

Early versus Delayed Surgery for Spinal Epidural Abscess : Clinical Outcome and Health-Related Quality of Life

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