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Prevention and Treatment of Postoperative Pain after Lumbar Spine Procedures: A Systematic Review
- Source :
- Pain practice : the official journal of World Institute of Pain. 18(7)
- Publication Year :
- 2017
-
Abstract
- Background and objective In the past 2 decades, in developed countries, spine procedures (surgical and percutaneous) had the highest absolute increase in case volume trend. The optimal approach to prevent and treat postoperative pain is continuously evolving. This systematic literature review presents evidence on safety and efficacy of pharmacological and nonpharmacological therapies to prevent and treat postoperative pain after lumbar spine procedures. Databases and data treatment Publications listed in PUBMED and EMBASE were considered to identify randomized clinical trials suitable for inclusion in this systematic review. Key words for literature search were selected, with authors' agreement, using the PICOS approach (participants, interventions, comparisons, outcomes, and study design). Results Fifty-nine randomized clinical trials (involving a total of 4,238 patients, with ages ranging from 18 to 86 years) published between January 2012 and September 2017 were retrieved. Data are presented according to the timing of therapy administration. Conclusion and recommendations Clinical evidence on perioperative pain management in patients undergoing spine procedures have significantly evolved after the review published in 2012. The aim of this systematic review was to report the latest evidence published. These include the preoperative use of dexamethasone, which was shown to be able to reduce pain at mobilization but not to reduce pain at rest or total morphine consumption; the use of gabapentinoids as part of a multimodal analgesic approach; and the safety and effectiveness of the intraoperative use of ketamine, dexketoprofen, and tramadol. Finally, electrical nerve stimulation is gaining interest and is potentially suitable for clinical needs.
- Subjects :
- Adult
medicine.medical_specialty
Percutaneous
spine procedures
Adolescent
Analgesic
Psychological intervention
Pain
law.invention
03 medical and health sciences
Young Adult
0302 clinical medicine
Randomized controlled trial
prevention
030202 anesthesiology
law
80 and over
Medicine
Humans
Pain Management
Postoperative
electrical stimulation therapies
lumbar surgery
neuroanesthesia
postoperative pain
treatment
Aged
Aged, 80 and over
Lumbar Vertebrae
Middle Aged
Pain, Postoperative
business.industry
Perioperative
Dexketoprofen
Anesthesiology and Pain Medicine
Systematic review
Physical therapy
Tramadol
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 15332500
- Volume :
- 18
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- Pain practice : the official journal of World Institute of Pain
- Accession number :
- edsair.doi.dedup.....d17c69141db77673135ccda9ab783c47