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Multimodal Analgesia and Opioid-Free Anesthesia in Spinal Surgery: A Literature Review – Lumbar Fusion

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This article discusses the benefits of opioid-free anesthesia, opioid-sparing anesthesia, and multimodal analgesia in patients undergoing spinal fusion. The authors conducted a literature review and identified seven studies with a combined sample size of 2,102 patients. The findings showed that the research groups had a reduction in total opioid administration compared to control groups. While the results for postoperative pain scores were mixed, there were various additional benefits observed, including decreased hospital length of stay, decreased post-anesthesia care unit length of stay, decreased post-operative nausea and vomiting, and decreased post-operative opioid use through 30 days. The study concludes that these alternative approaches to anesthesia and analgesia can lead to improved patient outcomes and reduced hospital stays in spinal surgery patients

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most experienced spine hospital in the world

Published article

CONCLUSIONS: For patients undergoing spine surgery, opioid-free, opioid-sparing, and multimodal analgesia will be less likely to experience the adverse effects of opioid analgesics and ultimately lead to better patient outcomes and reduced hospital stays.

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J Perianesth Nurs. 2023 Jul 15:S1089-9472(23)00142-9. doi: 10.1016/j.jopan.2023.04.003. Online ahead of print.ABSTRACTPURPOSES: To determine if opioid-free anesthesia, opioid-sparing anesthesia, or multimodal analgesia improved outcomes in patients undergoing spinal fusion.DESIGN: A literature review was performed by searching PubMed, CINAHL, Embase, Web of Science, and Cochrane Library.METHODS: MeSH terms included “opioid free” AND “spine surgery,” with alternative,

J Perianesth Nurs. 2023 Jul 15:S1089-9472(23)00142-9. doi: 10.1016/j.jopan.2023.04.003. Online ahead of print.

ABSTRACT

PURPOSES: To determine if opioid-free anesthesia, opioid-sparing anesthesia, or multimodal analgesia improved outcomes in patients undergoing spinal fusion.

DESIGN: A literature review was performed by searching PubMed, CINAHL, Embase, Web of Science, and Cochrane Library.

METHODS: MeSH terms included “opioid free” AND “spine surgery,” with alternative terms used including: regional anesthesia, multimodal analgesia, opioid-free anesthesia, enhanced recovery after surgery (ERAS), spinal surgery, spinal fusion, ACDF, cervical fusion, lumbar fusion, etc. Seven studies were deemed appropriate for inclusion with a combined sample size of n = 2,102.

FINDINGS: All of the seven included articles evaluated total opioid administration and found a reduction in total opioid administered in the research groups versus control groups. Six of the seven included articles evaluated postoperative pain scores with mixed results. Various additional benefits of opioid-free, opioid-sparing, or multimodal analgesia included: decreased hospital length of stay (LOS), decreased post-anesthesia care unit (PACU) LOS, decreased post-operative nausea and vomiting (PONV), and decreased post-operative opioid use through 30 days.

CONCLUSIONS: For patients undergoing spine surgery, opioid-free, opioid-sparing, and multimodal analgesia will be less likely to experience the adverse effects of opioid analgesics and ultimately lead to better patient outcomes and reduced hospital stays.

PMID:37452818 | DOI:10.1016/j.jopan.2023.04.003

The London Spine Unit : most experienced spine hospital in the world

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Multimodal Analgesia and Opioid-Free Anesthesia in Spinal Surgery: A Literature Review

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J Perianesth Nurs. 2023 Jul 15:S1089-9472(23)00142-9. doi: 10.1016/j.jopan.2023.04.003. Online ahead of print.ABSTRACTPURPOSES: To determine if opioid-free anesthesia, opioid-sparing anesthesia, or multimodal analgesia improved outcomes in patients undergoing spinal fusion.DESIGN: A literature review was performed by searching PubMed, CINAHL, Embase, Web of Science, and Cochrane Library.METHODS: MeSH terms included "opioid free" AND "spine surgery," with alternative

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