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. 2015 Feb 19;50(1):72-6.
doi: 10.1016/j.rboe.2015.02.005. eCollection 2015 Jan-Feb.

Immediate postoperative pain level from lumbar arthrodesis following epidural infiltration of morphine sulfate

Carlos Alexandre Botelho do Amaral  1 , Tertuliano Vieira  1 , Edgar Taira Nakagawa  1 , Eduardo Aires Losch  1 , Pedro José Labronici  1
Affiliations

Immediate postoperative pain level from lumbar arthrodesis following epidural infiltration of morphine sulfate

Carlos Alexandre Botelho do Amaral et al. Rev Bras Ortop. .

Abstract
in English, Portuguese

Objective: To evaluate the pain level in patients treated with epidural infusion of morphine sulfate in a single dose, after a surgical procedure to perform lumber arthrodesis.

Methods: Forty patients underwent posterolateral lumbar arthrodesis or intersomatic lumbar arthrodesis via a posterior route at one, two or three levels. They were prospectively randomized into two groups of 20. In the first group (study group), 2 mg of morphine sulfate diluted in 10 mL of physiological serum was infiltrated into the epidural space, through the laminectomy area. The second group (controls) did not receive analgesia. The patients were asked about their pain levels before and after the operation, using a visual analog scale (VAS).

Results: It was found that the patients presented a significant diminution of pain as shown by the VAS. From before to after the operation, it decreased by an average of 4.7 points (p = 0.0001), which corresponded to 53.2% (p = 0.0001).

Conclusion: Application of 2 mg of morphine sulfate in a single epidural dose was shown to be a good technique for pain therapy following lumbar spinal surgery.

Objetivo: avaliar o nível de dor em pacientes tratados com infusão epidural de sulfato de morfina em Dose única, após procedimento cirúrgico de artrodese lombar.

Métodos: Foram submetidos à artrodese lombar posterolateral ou artrodese lombar intersomática por via posterior, em um, dois ou três níveis, 40 pacientes, divididos, prospectivos e randomizados em dois grupos de 20. No primeiro grupo (de estudo) foram infiltrados no espaço epidural, através da área da laminectomia, 2 mg de sulfato de morfina diluídos em 10 mL de soro fisiológico. O segundo grupo (controle) não recebeu analgesia. Os pacientes foram interrogados quanto ao nível de dor, no pré e pós-operatório, com o uso da escala visual analógica (EVA).

Resultados: Verificou-se que os pacientes apresentaram uma queda significativa da dor pela EVA. A dor entre o pré e o pós-operatório diminuiu em média 4,7 pontos (p = 0,0001), o que corresponde a 53,2% (p = 0,0001).

Conclusão: Aplicação de 2 mg de sulfato de morfina, em dose única epidural, demonstrou ser uma boa técnica na terapia da dor após cirurgia na coluna lombar.

Keywords: Arthrodesis; Epidural analgesia; Morphine; Postoperative pain; Vertebral fusion.

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