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Multimodal Analgesia Lessens Post-Op Morphine Needs

Combination regimen lowers pain scores after lumbar decompressive laminectomy

FRIDAY, Aug. 23 (HealthDay News) -- A multimodal analgesia combination appears to be safe and effective for pain relief after lumbar decompressive laminectomy, according to a study published in the August issue of the Journal of Spinal Disorders & Techniques.

Ryan Michael Garcia, M.D., from the Case Western Reserve University in Cleveland, and colleagues randomly assigned 22 patients undergoing a primary multilevel lumbar decompression procedure to receive either intravenous morphine alone or a multimodal (celecoxib, pregabalin, extended release oxycodone) analgesic regimen. All patients, postoperatively, could receive intravenous morphine on an as-needed basis. A visual analog pain scale was used to assess postoperative pain levels which were documented at zero, four, eight, 12, 16, 24, and 36 hours.

The researchers observed no significant differences in available patient demographics, intraoperative blood loss, or postoperative hemovac drain output between study groups. Patients randomized to receive the multimodal analgesic regimen had lower total postoperative intravenous morphine requirements and lower morphine requirements at all predetermined time points. Patients receiving the multimodal analgesic regimen also had lower visual analog pain scores at all postoperative time points. Neither treatment group had major identifiable postoperative complications.

"Opioid and non-opioid analgesic combinations appear to be safe and effective after lumbar laminectomy," the authors write.

Abstract (http://journals.lww.com/jspinaldisorders/Abstract/2013/08000/A_Multimodal_Approach_for_Postoperative_Pain.1.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/jspinaldisorders/Abstract/2013/08000/A_Multimodal_Approach_for_Postoperative_Pain.1.aspx )