How Epidurals Can Help Spine-Driven ASCs

Spine

At the 11th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago on June 14, Fred Geisler, MD, PhD, a neurosurgeon at the Chicago Back Institute at Swedish Covenant Hospital, outlined the benefits of an intraoperative epidural anesthetic injection after lumbar spinal surgery. Dr. Geisler said in the current medical literature, many patients have moderate to severe pain 24 hours after ambulatory surgery. "Pain even has a definite detrimental effect [with increased death rate], which I found kind of surprising, but it's in the literature," Dr. Geisler said.

Among intramuscular analgesia, patient-controlled analgesia and epidural, Dr. Geisler said the epidural had the most significant effect in reducing post-operative pain for spine surgery patients, according to the literature.

To test that thesis further, Dr. Geisler conducted a study. In a retrospective chart review of 168 lumbar spine surgeries he and others performed, 133 patients received epidural medications at the end of their case. Dr. Geisler found that the maximum pain for patients who received the epidural was far less (a 1.7 pain rating on a scale of 10) compared with those who received no medication (5.3 out of 10).

"This appears to be safe and effective in post-operative pain management," Dr. Geisler concluded. It led to less lumbar muscle spasms, a more reliable neurologic examination of the patient later on and overall much happier patients, he added.

More Articles on the Becker's Orthopedic, Spine and Pain Management ASC Conference:

Electrical Anesthesia: The Future of Non-Opioid Pain Relief? 

4 Strategies for Running an Efficient, Market-Driven Pain Management ASC

Drs. Richard Kube & David Rothbart: 3 Key Considerations for the Transition of Spine to ASCs

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