Minimally invasive spine surgery pain management: Is multimodal or patient –controlled analgesia better? 5 key findings

Written by Laura Dyrda | July 31, 2017 | Print  |

A new study published in Spine examines multimodal analgesia and intravenous patient-controlled analgesia for minimally invasive transforaminal lumbar interbody fusion.


The study authors examined one-level TLIF patients who either received a multimodal analgesic approach to pain management designed to decrease pain and narcotics after surgery or patient-controlled analgesia. There were 139 patients included in the study, with 39 in the multimodal analgesia group and 100 in the patient-controlled analgesia group. The study authors found:


1. The patients who received multimodal analgesia reported lower inpatient narcotic consumption and lower inpatient nausea and vomiting than the patient-controlled analgesia group.


2. A shorter length of stay was recorded for the multimodal analgesia group than the patient-controlled analgesia group.


3. The pain scores were similar in both groups after surgery as well as postop day one and two. There were also similar rates in postoperative urinary retention between both groups.


4. By six to 12 weeks after surgery, both groups reported the same rates of narcotic consumption.


5. The study authors concluded, "The decrease in narcotic consumption may contribute to the observed decrease in the rate of inpatient nausea/vomiting and shorter hospital length of stay. Importantly, MMA and PCA resulted in similar analgesic for patients during the inpatient stay."


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