Effect of Instillation of Morphine and Dexamethasone in Epidural Space on Postoperative Pain in Discectomy Operation
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K Tavakol 1, AH Daneshi , K Karimzadeh Shirazi |
1- , kamtavakol@yahoo.com |
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Abstract: (6830 Views) |
ABSTRACT:
Introduction & Objective: Discectomy for nucleous pulposus herniation is
one of he most surgeries in spinal column. In this surgical treatment,
postoperative pain is a problem which results in more hospital stay and
less daily activity. Postoperative pain control is difficult because opoids
don't relieve moderate and severe pain alone. It is believed that
corticosteroid and local anesthetic agents or narcotics improve sciatic pain.
In this study we compare the effect of different doses of morphine and
dexamethasone by placebo on post discectomy operative pain.
Materials & Methods: This is a randomized double blind clinical trial in
which 90 selected patients, ASA 1-2, with acute-onset herniated nucleus
pulposus that were refractory to conservative treatment were enrolled.
Subjects were randomly divided into 6 groups and underwent discectomy
under equal general anesthesia. Before the closure operational incision,
the first group received 5 cc lidocaine %2, second group 5cc normal saline
third group 0.5 mg morphine and 8 mg dexamethasone, forth group 1mg
morphine and 8 mg dexamethasone, fifth group 1.5 mg morphine and 8 mg
dexamethasone, and the last group 2 mg morphine for every level of
discectomy and 8mg dexamethasone . Drugs were flushed on dura matter
and operation field. Volume of all drugs was increased to 6 cc by adding
sterile distilled water. Postoperative back and radicular pain was scaled 6,
12, 18 and 24 hour after operation using visual analogue scale (VAS) and
recoded analgesic requirement. Collected data was analyzed by SPSS
software using Mann Whitney U and Kruskal-Wallis tests.
Results: patients of group 1 to 3 did not showed significant changes in
postoperative pain and consumption of analgesic, but when dose of
morphine increased, these changes became significant especially in dose
of 2 mg for every level of discectomy.
Conclusion: It seems that Instillation of morphine and dexamethasone in
epidural space after discectomy decreases patient’s postoperative pain
which result in reduction in narcotic use.
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Keywords: KEYWORDS:Discectomy, Epidural, Morphine, Dexamethasone, Postoperative Pain |
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Full-Text [PDF 137 kb]
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Type of Study: Research |
Subject:
Special Received: 2015/06/15 | Accepted: 2015/06/15 | Published: 2015/06/15
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