Objectives

Effective postoperative pain management after lumbar disc surgery reduces complications and improves postoperative care. The purpose of this prospective, randomized, double-blind, placebo-controlled clinical study is to evaluate the effects of IV paracetamol and ibuprofen on postoperative pain, morphine consumption and side effects of morphine in patients who underwent lumbar disc surgery.

Materials and methods

Seventy-five patients aged 18-85 years scheduled for lumbar disk surgery with a single level laminectomy included in this study. All patients received morphine with an IV patient-controlled analgesia device during the first postoperative 24 hour. The patients were divided randomly and double-blinded into three groups (control, paracetamol and ibuprofen). The demographic characteristics and procedure data, VAS score, cumulative morphine consumption, opioid-related side effects were recorded.

Results

There was no significant difference regarding to demographic characteristics, comorbidities, and durations of anesthesia and surgery. There was a significant difference between all groups regarding to total morphine consumption (P < 0.001). IV ibuprofen significantly reduced the total morphine consumption in comparison with control and paracetamol (P < 0.001). Repeated measures ANOVA showed in all periods of the study that VAS score was significantly lower in ibuprofen (P < 0.001), but not in paracetamol (P = 0.394) in comparison with control. There was no difference between groups regarding postoperative heart rate, mean arterial pressure, nausea-vomiting, pruritus and urinary retention.

Conclusions

This study showed that pain scores and morphine consumption, but not the side effects of patient-controlled analgesia during 24 hours after the lumbar disk surgery, were significantly reduced by IV ibuprofen as a supplemental analgesic when compared with controls and paracetamols.

中文翻译：

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静脉注射扑热息痛和布洛芬对腰椎间盘突出手术术后疼痛和吗啡消耗的疗效：前瞻性、随机、双盲、安慰剂对照临床试验

目标

腰椎间盘突出手术后有效的术后疼痛管理可减少并发症并改善术后护理。这项前瞻性、随机、双盲、安慰剂对照临床研究的目的是评估静脉注射扑热息痛和布洛芬对腰椎间盘手术患者术后疼痛、吗啡用量和吗啡副作用的影响。

材料和方法

75 名年龄在 18-85 岁之间的患者计划进行腰椎间盘手术并在本研究中包括单节段椎板切除术。所有患者在术后第一个 24 小时内接受吗啡和静脉患者自控镇痛装置。将患者随机和双盲分为三组（对照组、扑热息痛和布洛芬）。记录人口统计学特征和程序数据、VAS 评分、累积吗啡消耗量、阿片类药物相关的副作用。

结果

在人口统计学特征、合并症以及麻醉和手术持续时间方面没有显着差异。在吗啡总消耗量方面，所有组之间存在显着差异（P  <  0.001）。与对照组和扑热息痛相比，静脉注射布洛芬显着降低了吗啡的总消耗量 ( P  <  0.001)。重复测量方差分析显示，在研究的所有时期，与对照组相比，布洛芬的 VAS 评分显着降低（P  <  0.001），但扑热息痛（P  =  0.394）则不然。两组之间在术后心率、平均动脉压、恶心呕吐、瘙痒和尿潴留方面没有差异。

结论

该研究表明， 与对照组和扑热息痛相比，静脉注射布洛芬作为补充镇痛剂可显着降低疼痛评分和吗啡用量，但不能降低腰椎间盘手术后24小时内患者自控镇痛的副作用。