Comparative Analysis Of Three Methods For Postoperative Analgesia After Lumbar Posterior Surgery

Objective: Our study aims to compare the analgesic and PONV effects of three methods of posterior lumbar spinal surgery.Methods: From 2013 to 2015,we selected 25 patients which been undergo lumbar spine surgery.These patients are not allergic to these drugs.After taking the drug they did not appear adverse reactions,and These patients suffer no disease that does not apply to such drugs.These patients are already diagnosed with lumbar disease,and got no effect received conservative treatment after 6 months.Before surgery,t these patients are forbidden to take any narcotic drugs.Three groups of patients were randomized to receive three treatment regimens.The first group is the sustained release group,20 patients were selected for epidural slow release of small doses of morphine.The second group was analgesic pump group,22 patients were selected and injected intravenously with an automated analgesic pump.23 patients were selected and intermittent intramuscular injection was performed with pethidine.After surgery,the patient's pain intensity was continuously observed within 72 hours.The test situation is recorded in detail four times.4 hours after surgery,we conducted the first record,then record it once a day.With index 10 as the standard,10 represents the strongest pain and 0 represents no pain.The same method is deal with nausea and vomiting,10 represents the strongest feeling and 0 does no feel.and we recorded other adverse symptoms else,Such as hypotension,skindu itching,poor breathing,urinary retention and so on.The patient's rating the intensity of pain(visual analog scale score from 0(no pain)to 10(the most severe pain),nausea(from 0(no nausea)to 10(severe nausea),and vomiting(from 0(no vomiting)to 10(severe vomiting),were recorded after 4 hours,1 day,2 days,3 days.Results: There was no statistically significant difference between the patients(Fig.1).Before surgery,we gave the patient a pain score,and the results showed no difference.In addition to the pethidine trial group,the experimental data for both groups showed significant differences(P<0.01.In the first three observations after surgery,the first two groups were much better than the third group.)The results of the first and third observations after surgery showed that the analgesic effect of the sustained release group and the analgesia pump group was the same.The result of the second observation after surgery showed that the effect of the sustained-release group was significantly better than that of the analgesic pump group.The fourth observation showed no difference in the experimental results.There was no significant difference in the analgesic effect of epidural low-dose morphine group and intravenous controlled analgesia pump group after 1 and 2 days of the operation,compared with pyridine group(P < 0.05).At 1 days,2 days and 3 days after surgery,the nausea and vomiting(PONV)complications of the patients with the treatment of intravenous analgesia pump were more serious than the other two groups(P < 0.05).Conclusion: Epidural small dose morphine can effectively control the pain and minimize the degree of nausea and vomiting(PONV)after the operation of lumbar spine.