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Titolo:
LUMBAR DISKECTOMY - USE OF AN EPIDURAL MORPHINE SPONGE FOR POSTOPERATIVE PAIN CONTROL
Autore:
GIBBONS KJ; BARTH AP; AHUJA A; BUDNY JL; HOPKINS LN;
Indirizzi:
SUNY BUFFALO,SCH MED & BIOMED SCI,DEPT NEUROSURG,3 GATES CIRCLE BUFFALO NY 14209
Titolo Testata:
Neurosurgery
fascicolo: 6, volume: 36, anno: 1995,
pagine: 1131 - 1135
SICI:
0148-396X(1995)36:6<1131:LD-UOA>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
SPINAL SURGERY; DOUBLE-BLIND; ANALGESIA; RELIEF;
Keywords:
EPIDURAL MORPHINE ANALGESIA; GELFOAM SPONGE; LUMBAR DISKECTOMY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
23
Recensione:
Indirizzi per estratti:
Citazione:
K.J. Gibbons et al., "LUMBAR DISKECTOMY - USE OF AN EPIDURAL MORPHINE SPONGE FOR POSTOPERATIVE PAIN CONTROL", Neurosurgery, 36(6), 1995, pp. 1131-1135

Abstract

A TECHNIQUE FOR extended ambulatory epidural pain control after lumbar discectomy is described; preliminary results with 45 patients are reported; and alternative methods of narcotic analgesia are reviewed. Inthis technique, an absorbable gelatin sponge (Gelfoam, Upjohn Co., Kalamazoo, MI) is contoured to the laminotomy defect, placed in methylprednisolone acetate (40-80 mg), and then injected with 2 to 4 mg of preservative-free morphine (a small needle was used to fill the sponge). The sponge is placed over the defect before closure. A review of office and hospital records was conducted. The series consisted of 33 men and 12 women (mean age, 39 yr; range, 24-57 yr); records showed narcotic use in 34 patients (parenteral in 3) and work-related injuries in 14patients. Thirty-three patients were ambulatory postoperatively on the day of surgery; all were ambulatory by postoperative day (POD) 1. Onthe day of surgery, 18 patients did not require any postoperative analgesics; on POD 1, 22 patients did not require analgesics. Six patients received parenteral narcotics; four received one dose only, and two had two or more doses. Thirty-one patients were discharged from the hospital on POD 1, and 10 were discharged POD 2. The other patients weredischarged from the hospital on POD 3 (three patients) or POD 4 (one patient). When they were discharged, all patients received a limited supply of acetaminophen with codeine for pain control at home. After discharge, phone follow-up (at 1 week) and office follow-ups (at 3-5 weeks) revealed only one patient with more than mild discomfort. Three patients required one-time bladder catheterization, and one patient had presumed discitis 1 month postoperatively. In a control group who had undergone surgery 3 months previously, the average day of discharge had been POD 3.07; no control patient had been discharged on POD 1, and only 20% had been discharged on POD 2. This method provides effective,safe, and extended analgesia after lumbar discectomy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 15:34:41