title: Insufficient pain management after spine surgery.
abstract: BACKGROUND
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Anæstesiologisk Afdeling, Glostrup Hospital, Nordre Ringvej 57, 2600 Glostrup, Denmark. rikkesoennichsen@gmail.com.
authors.forename: Rikke Vibeke
authors.initials: RV
authors.lastname: Nielsen
authors.forename: Jonna Storm
authors.initials: JS
authors.lastname: Fomsgaard
authors.forename: Jørgen Berg
authors.initials: JB
authors.lastname: Dahl
authors.forename: Ole
authors.initials: O
authors.lastname: Mathiesen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage* / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D059408:Pain Management / Q000592:standards*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D013123:Spinal Fusion / Q000009:adverse effects
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid