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Does continuous wound infiltration enhance baseline intravenous multimodal analgesia after posterior spinal fusion surgery? A randomized, double-blinded, placebo-controlled study

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العنوان: Does continuous wound infiltration enhance baseline intravenous multimodal analgesia after posterior spinal fusion surgery? A randomized, double-blinded, placebo-controlled study
المؤلفون: Jean François Payen, Olivier Palombi, Pascal Incagnoli, Jean-Louis Quesada, P. Albaladejo, Jérôme Tonetti, Arnaud Vighetti, Jules Greze, J.-L. Bosson
المساهمون: Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), Hypoxie et physiopathologies cardiovasculaire et respiratoire, Institut National de la Santé et de la Recherche Médicale (INSERM), CIC - Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Techniques pour l'Evaluation et la Modélisation des Actions de la Santé (TIMC-IMAG-ThEMAS), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Intuitive Modeling and Animation for Interactive Graphics & Narrative Environments (IMAGINE ), Inria Grenoble - Rhône-Alpes, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Laboratoire Jean Kuntzmann (LJK ), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), CHU de Grenoble ortho-traumato (CHU-Grenoble ortho-traumato), Ministère de la santé, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Neuro-imagerie fonctionnelle et métabolique (ANTE-INSERM U836, équipe 5), Grenoble Institut des Neurosciences (GIN), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hypoxie : Physiopathologie Respiratoire et Cardiovasculaire (HP2 ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])
المصدر: European Spine Journal
European Spine Journal, Springer Verlag, 2017, 26 (3), pp.832-839. ⟨10.1007/s00586-016-4428-1⟩
European Spine Journal, 2017, 26 (3), pp.832-839. ⟨10.1007/s00586-016-4428-1⟩
سنة النشر: 2015
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Placebo-controlled study, MESH: Anesthesia, Infiltration, Orthopedics, Pain, Postoperative, 03 medical and health sciences, 0302 clinical medicine, Nefopam, 030202 anesthesiology, medicine, Humans, Orthopedics and Sports Medicine, Ketamine, Saline, Acetaminophen, Analgesics, Pain, Postoperative, Morphine, Ropivacaine, business.industry, Analgesia, Patient-Controlled, Middle Aged, 3. Good health, Surgery, Catheter, Continuous wound infiltration, Spinal Fusion, Anesthesia, Female, business, 030217 neurology & neurosurgery, medicine.drug
الوصف: International audience; PURPOSE:There has been a growing interest in continuous local anaesthetic wound infiltration as a non-opioid technique for postoperative pain relief. The impact of this modality on baseline analgesia after spinal fusion surgery has however been inconclusive. We tested whether continuous wound infiltration with ropivacaine can enhance postoperative analgesia compared to a baseline intravenous multimodal analgesia protocol after spinal fusion surgery.METHODS:In this randomized, double-blinded, placebo-controlled study, a multiholed 19-gauge catheter was placed at the end of the surgical procedure through the wound to permit the continuous administration (8 ml/h) of ropivacaine 0.2 % (ropivacaine group; n = 19 patients) or saline (control group; n = 20 patients) during the first 48 postoperative hours (H48). Both groups received intraoperative low-dose ketamine, a combination of acetaminophen, non-steroidal anti-inflammatory drug, and nefopam over the same postoperative period, and morphine delivered by a patient-controlled analgesia (PCA) device.RESULTS:Morphine consumption was comparable between the two groups both at H48, 38 mg (26:52) (median, 25th:75th percentile) (control group) versus 43 mg (19:74) (ropivacaine group), and at H24, 18 mg (16:22) versus 22 mg (9:35) respectively. Pain scores at rest and during mobilization, quality of postoperative sleep, and morphine-related side effects were comparable between the two groups at H24 and H48.CONCLUSION:Our findings indicate that no additional analgesia was provided with continuous wound infiltration of ropivacaine compared to a baseline intravenous multimodal analgesia protocol after spinal fusion surgery.TRIAL REGISTRATION:Clinicaltrials.gov #NCT01743794.
تدمد: 1432-0932
0940-6719
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f5a8cfa7861293671071c9256b2b70e4
https://pubmed.ncbi.nlm.nih.gov/26865083
حقوق: CLOSED
رقم الأكسشن: edsair.doi.dedup.....f5a8cfa7861293671071c9256b2b70e4
قاعدة البيانات: OpenAIRE
الوصف
تدمد:14320932
09406719