Insufficient pain management after spine surgery

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  • Rikke Vibeke Nielsen
  • Jonna Storm Fomsgaard
  • Jørgen Berg Dahl
  • Mathiesen, Ole

Introduction: A prospective observational quality assurance study was performed at Glostrup Hospital, Denmark, to describe patients undergoing spine surgery with regard to perioperative analgesic management, post-operative pain, opioid consumption and side effects. Material and methods: Patients eligible for the study were identified consecutively from the operation chart. The following data were registered: post-operative visual analogue (VAS) pain score at rest and during mobilisation, opioid consumption for the first 24 h, other analgesics administered and side effects. Results: A total of 87 patients were included. For instrumented lumbar fusion patients (n = 24), the VAS pain scores at 1, 4 and 24 h after surgery were (median (interquartile range)) 5 (0-7), 2.5 (0-8) and 5.5 (0-9) at rest and 5 (0-8), 3 (0-9) and 7 (3-9) during mobilisation, respectively. The other surgical subgroups generally experienced VAS ≤ 3. For instrumented lumbar fusion, the total 0-24 h consumption of intravenous morphine equivalents was 39.1 (27.5-62.7) mg. Only eight of 87 patients received the entire scheduled standard post-operative pain treatment. Adverse events were rare. Conclusion: Most patients experienced acceptable pain levels, but instrumented lumbar fusion leads to moderate to severe pain levels and a relatively high opioid consumption. The scheduled standard pain management protocols were sparsely followed. Challenges exist in post-operative pain management as observed in previous surveys, especially for instrumented lumbar fusion surgery. Future work should focus on optimising treatment plans.

Original languageEnglish
Article numberA4835
JournalDanish Medical Journal
Volume61
Issue number5
ISSN2245-1919
Publication statusPublished - May 2014

ID: 390176183