Insufficient pain management after spine surgery

Area of Science:

• Orthopedics
• Pain Management
• Neurosurgery

Background:

• A quality assurance study at Glostrup Hospital, Denmark, investigated perioperative analgesic management, pain, opioid consumption, and side effects in spine surgery patients.
• Understanding patient outcomes is crucial for improving post-operative care standards.

Purpose of the Study:

• To describe the analgesic management, pain experience, and opioid use in patients undergoing spine surgery.
• To identify challenges in post-operative pain management, particularly for instrumented lumbar fusion.

Main Methods:

• Prospective observational study including 87 patients undergoing spine surgery.
• Data collected included post-operative Visual Analogue Scale (VAS) pain scores (rest and mobilization), 24-hour opioid consumption, other analgesics, and adverse events.

Main Results:

• Instrumented lumbar fusion patients (n=24) reported moderate to severe pain (median VAS 5.5 at rest, 7 during mobilization at 24h) and high opioid consumption (39.1 mg IV morphine equivalents).
• Other surgical subgroups generally experienced VAS ≤ 3.
• Only 8 of 87 patients received the full scheduled pain treatment; adverse events were infrequent.

Conclusions:

• While most patients experienced acceptable pain, instrumented lumbar fusion is associated with significant pain and high opioid requirements.
• Adherence to standard post-operative pain management protocols was low, indicating challenges in current practices.
• Optimizing treatment plans is essential, especially for instrumented lumbar fusion surgery, to address persistent pain management issues.