title: The effect of epidural low-dose morphine-soaked microfibrillar collagen sponge in postoperative pain control after laminectomy and instrumented fusion: a randomized double-blind placebo-controlled study.
abstract: OBJECTIVE
  To evaluate the postoperative analgesic effect and postoperative nausea and vomiting (PONV) after using epidural low-dose morphine-soaked microfibrillar collagen sponge (MMCS), as compared with placebo.
  
  
  METHODS
  A prospective randomized double-blind placebo-controlled study was performed on patients under-going single-level posterior lumbar spinal decompression and instrumented fusion at the Department of Orthopedic Surgery, Siriraj Hospital, between August 2012 and December 2013. Patients were randomly allocated into two groups to receive either an epidural MMCS or an epidural normal saline-soaked microfibrillar collagen sponge (placebo). Intensity ofpain, PONV and total amount of morphine were recorded at 4, 24, 48, and 72 hours, postoperatively.
  
  
  RESULTS
  The analgesic effect was enhanced significantly in the epidural MMCS group, as the amount ofmorphine used was statistically less than in the placebo group at 4 and 24 hours (p < 0.05).
  
  
  CONCLUSIONS
  A single low-dose epidural MMCS is effectiveforpain control after posterior lumbar spinal surgery with a low incidence of PONV.
authors.forename: Sirichai
authors.initials: S
authors.lastname: Wilartratsami
authors.forename: Vimolluck
authors.initials: V
authors.lastname: Sanansilp
authors.forename: Thanase
authors.initials: T
authors.lastname: Ariyawatkul
authors.forename: Chatupon
authors.initials: C
authors.lastname: Chotigavanichaya
authors.forename: Witchate
authors.initials: W
authors.lastname: Pichaisak
authors.forename: Areesak
authors.initials: A
authors.lastname: Chotivichit
authors.forename: Panya
authors.initials: P
authors.lastname: Luksanapruksa
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D015360:Analgesia, Epidural / Q000295:instrumentation*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000818:Animals; D019299:Decompression, Surgical; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D013123:Spinal Fusion
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine