Postoperative Analgesia After Lumbar Laminectomy

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Abstract
We compared the efficacy and safety of continuous epidural fentanyl infusion with intravenous morphine via a patient-controlled analgesia system (IV-PCA) in the management of postoperative pain after lumbar laminectomy. Twenty patients undergoing elective lumbar laminectomy were randomly allocated to one of two groups. The epidural group (n = 10) received an epidural fentanyl infusion (2 micro gram/mL at 4-10 mL/h) while the IV-PCA group (n = 10) received IV morphine through a PCA system. The general anesthetic technique was standardized. Visual analog pain scores were recorded at 12, 24, and 48 h after the operation. The amount of morphine (or its equivalent in fentanyl) used over the 48-h postoperative period was documented. The postoperative pain scores were significantly lower in the epidural group than in the IV-PCA group throughout the study period. The total consumption of morphine (or its fentanyl equivalent) over the 48-h period was significantly lower (P (Anesth Analg 1995;80:511-4)