Complex perioperative pain management in the treatment of patients with degenerative lumbar spine diseases

Byvaltsev V.A.; Goloborodko V.Yu.; Kalinin A.A.; Pestryakov Yu.Ya.; Shepelev V.V.

doi:https://doi.org/10.17116/pain20201804124

Byvaltsev V.A.

Irkutsk State Medical University;
Private Healthcare Institution «Clinical Hospital «Russian Railways-Medicine»;
Irkutsk State Medical Academy of Postgraduate Education

Goloborodko V.Yu.

Irkutsk State Medical University;
Private Healthcare Institution «Clinical Hospital «Russian Railways-Medicine»

Kalinin A.A.

Irkutsk State Medical University;
Private Healthcare Institution «Clinical Hospital «Russian Railways-Medicine»

Pestryakov Yu.Ya.

Irkutsk State Medical University

Shepelev V.V.

Irkutsk State Medical University

Complex perioperative pain management in the treatment of patients with degenerative lumbar spine diseases

Authors:

Byvaltsev V.A., Goloborodko V.Yu., Kalinin A.A., Pestryakov Yu.Ya., Shepelev V.V.

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Journal: Russian Journal of Pain. 2020;18(4): 24‑30

DOI: 10.17116/pain20201804124

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To cite this article:

Byvaltsev VA, Goloborodko VYu, Kalinin AA, Pestryakov YuYa, Shepelev VV. Complex perioperative pain management in the treatment of patients with degenerative lumbar spine diseases. Russian Journal of Pain. 2020;18(4):24‑30. (In Russ.)
https://doi.org/10.17116/pain20201804124

Подписка 2025 Российский журнал боли (Russian Journal of Pain)

Использование инфографики авторами научных работ

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OBJECTIVE

To analyze the effect of complex perioperative pain management on postoperative pain syndrome and cognitive functions in patients with degenerative lumbar spine diseases.

MATERIAL AND METHODS

A prospective study included 85 patients with degenerative lumbar spine diseases. Two groups were distinguished. In the control group (n=42), conventional surgical technologies and anesthesia were used. In the main group (n=43), we additionally applied multimodal perioperative analgesia. Comparative analysis included VAS score of pain syndrome and need for pain relief, Montreal Cognitive Assessment Score (MoCA) and Frontal Assessment Battery (FAB) score.

RESULTS

Less VAS score and in-hospital need for analgesia were observed in the main group compared to the control group (p<0.001). Twenty-seven patients (62.8%) in the main group did not require painkillers since the 6^th postoperative day. According to MoCA and FAB scores, postoperative cognitive functions were significantly better in the main group (p<0.05). Mild-to-moderate cognitive impairment was detected in 29 (69%) and 7 (16.3%) patients in the main and control group, respectively (p=0.007). There was a greater number of adverse effects following anesthesia in the control group (28.6% and 9.3%, respectively, p=0.004).

CONCLUSION

Complex perioperative anesthesia with preoperative administration of ketoprofen, intraoperative injection of dexmedetomidine and postoperative administration of paracetamol and wound edge infiltration with ropivacaine is effective and safe approach. These measures significantly reduce severity of local pain syndrome, incidence of cognitive disorders and risk of adverse anesthesia-induced effects.

Keywords:

lumbar spine

degenerative diseases

spinal surgery

postoperative pain syndrome

multimodal perioperative analgesia

cognitive functions

prevention of cognitive dysfunction

Authors:

Byvaltsev V.A.

Irkutsk State Medical University;
Private Healthcare Institution «Clinical Hospital «Russian Railways-Medicine»;
Irkutsk State Medical Academy of Postgraduate Education

Goloborodko V.Yu.

Irkutsk State Medical University;
Private Healthcare Institution «Clinical Hospital «Russian Railways-Medicine»

Kalinin A.A.

Irkutsk State Medical University;
Private Healthcare Institution «Clinical Hospital «Russian Railways-Medicine»

Pestryakov Yu.Ya.

Irkutsk State Medical University

Shepelev V.V.

Irkutsk State Medical University

Received:

24.10.2020

Accepted:

27.10.2020

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References:

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