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Efficacy of Topical Microfibrillar Collagen Mixed with Steroid Hormone and Morphine for Postoperative Pain Control during Lumbar Laminectomy: A Preliminary Report

Author(s): Tzu-Yung Chen

Journal: Chang Gung Medical Journal
ISSN 2072-0939

Volume: 25;
Issue: 02;
Start page: 81;
Date: 2002;
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Keywords: epidural morphine | methylprednisolone | laminectomy | pain

Background: Current inpatient management of postoperative pain in lumbar surgeryincludes the use of intramuscular opioid analgesics, nonsteroidal anti-inflammatorydrugs, or patient-controlled analgesia; however, all types of medicationsare associated with side effects that can limit their usefulness in theinpatient setting.Methods: In a well-conducted non-randomized prospective trial, 80 consecutivepatients who underwent elective multilevel lumbar laminectomy surgerywere identified. Two types of trials with different doses of steroids wereused. Patients' preoperative medical records, pain scores, narcotics consumption,costs for the regimen, hospital stay, unwanted complications, andwalking ability were evaluated postoperatively.Results: Pain in patients after lumbar surgery can be dramatically controlled postoperatively.Seventy-eight patients (97.5%) were able to walk without support onthe first postoperative day. Major side effects were found in 5 patients(6.2%).Conclusions: This experience indicates that pain-control agents with epidural sustainedreleasedpreparation seem to be beneficial in early mobilization, are costeffective, and require lower analgesic consumption by patients. Similar paincontrol can be obtained with lower doses of methylprednisolone. In spite ofits clinical attractiveness, improvements in the side effects of complicationsfrom epidural morphine and the combination of steroids and microfibrillarcollagen have yet to be realized.
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