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Meaningful Improvement in Perioperative Pain Control After Lumbar Surgery: Commentary on an article by Hyun Kang, MD, et al.: "Early Postoperative Analgesic Effects of a Single Epidural Injection of Ropivacaine Administered Preoperatively in Posterior Lumbar Interbody Spinal Arthrodesis. A Pilot Randomized Controlled Trial".

University of Texas Southwestern Medical Center at Dallas, Dallas, Texas.
The Journal of Bone and Joint Surgery (Impact Factor: 5.28). 03/2013; 95(5):e301-2. DOI: 10.2106/JBJS.L.01645
Source: PubMed

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Available from: jbjs.org
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    ABSTRACT: This meta-analysis aimed to compare the postoperative analgesic effects of patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (PCIA) for patients undergoing spinal fusion surgeries. Relevant articles were identified using computerized and manual search strategies. Statistical analyses were undertaken by the CMA 2.0 statistical software. Nine cohort studies with a total of 436 patients undergoing spinal fusion surgeries were incorporated in the present meta-analysis. There were significant differences between the PCEA and PCIA groups in the visual analogue scale score of patients undergoing spinal fusion [standardized mean difference = 0.27, 95 % confidence interval (95 % CI) = 0.070-0.470, P = 0.008]. However, no obvious difference was observed in the rate of side effects between the PCIA and PCEA groups (side effects: odds ratio = 0.957, 95 % CI = 0.536-1.708, P = 0.882). Our findings suggested that PCEA may be more effective in relieving pain than PCIA for patients undergoing spinal fusion surgeries.
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