Postoperative Analgesia and Recovery with IV-PCA Morphine and Diclofenac Suppository after Spinal Surgery

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  • SATSUMAE Tsuyoshi
    Department of Anesthesiology, Faculty of Medicine, University of Tsukuba
  • TANAKA Makoto
    Department of Anesthesiology, Faculty of Medicine, University of Tsukuba

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  • 経静脈モルヒネ自己調節鎮痛とジクロフェナク坐剤併用による脊椎手術後の鎮痛と回復

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Abstract

  This study was designed to examine the efficacy of combination therapy with intravenous morphine and diclofenac suppository after spinal surgeries. Following informed consent, 32 patients undergoing elective spinal surgeries were studied. They were randomly assigned, according to the postoperative analgesic regimen, to either the morphine (M) group (n=16), who received IV-PCA morphine alone, or the morphine+diclofenac (M+D) group (n=16), who received, in addition to morphine PCA, diclofenac suppositories 50 mg every 6 h starting immediately before surgical incision for 48 h. Postoperative analgesic profiles, extent of side effects, and other complications were assessed using unpaired t-test, chi-squared test and Mann-Whitney U-test, with P < 0.05 being significant. Median pain score was lower in the M+D group. Postoperative morphine consumption and the extent of side effects (nausea/vomiting and sedation) were less in the M+D group. Time to first oral intake and bowel movement was shorter in the M+D group. Our data justify the combination therapy using IV-PCA morphine and diclofenac suppository for post-spinal surgery analgesia and recovery.

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