Abstract
Comparative evaluation of different doses of gabapentin and celecoxib as multimodal oral analgesia in patients of spine fixation surgery
Highlights
A number of studies have focused on pain treatment in spine surgery, but most studies have focused on primary degenerative conditions in the lumbar spine treated with discectomy, decompression and lumbosacral fusion .Since an increased number of major spinal procedures, including revision surgery can be anticipated, we found it of relevance to assess a multimodal pain treatment strategy in patients undergoing surgery requiring instrumentation (Mathiesen et al, 2013)
Patients and Methods After obtaining the local ethics committee of Minia University Hospital approval and written informed consent was taken from the patient, one hundred patients of both gender, American society of anesthesiologists (ASA) I and II,aged between 20-60 years old scheduled to undergo elective posterior approach lumbar spine fixation surgery ( 3 levels or less) done by the same surgeon under general anesthesia, were enrolled in this prospective, randomized, double blinded controlled study
Spinal procedures are associated with high level of postoperative pain compared to other surgical procedures and majority of patients report moderate to severe pain, which persists for at least initial 3-4 days
Summary
Since an increased number of major spinal procedures, including revision surgery can be anticipated, we found it of relevance to assess a multimodal pain treatment strategy in patients undergoing surgery requiring instrumentation. A number of studies have focused on pain treatment in spine surgery, but most studies have focused on primary degenerative conditions in the lumbar spine treated with discectomy, decompression and lumbosacral fusion .Since an increased number of major spinal procedures, including revision surgery can be anticipated, we found it of relevance to assess a multimodal pain treatment strategy in patients undergoing surgery requiring instrumentation (Mathiesen et al, 2013). Multimodal analgesia, which combines analgesic drugs from different classes and employs analgesic techniques that target different mechanisms of pain, is recommended in the treatment of acute postoperative and Comparative evaluation of different doses of gabapentin and celecoxib as multimodal oral analgesia trauma-related pain because its synergistic effect maximizes pain relief at lower analgesic doses, thereby reducing the risk of adverse drug effects (Polomano et al, 2017) Acute postoperative pain remains to be a major problem, and inadequate or excessive treatment can cause side effect including increased risk of myocardial ischemia or infarction ,thromboembolic and pulmonary complications, persistent postoperative pain incidence, alterations in immune system, impaired rehabilitation, increased hospital stay or readmissions to the hospital, impaired quality of life, and excessive sedation due to opioid use .There are developments regarding novel analgesic medical treatments and techniques to be employed in preoperative, intraoperative, and postoperative periods to better manage acute postoperative pain (Gordon et al, 2016).
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