title: A prospective randomized comparative study of postoperative pain control using an epidural catheter in patients undergoing posterior lumbar interbody fusion.
abstract: To assess the efficacy of continuous epidural infusion analgesia (ED) with 0.2 % Ropivacaine versus IV PCA (Fentanyl) in spinal fusion surgery patients.
  
  
  
  A prospective randomized comparative clinical trial. Patients were randomized into one of two groups-the epidural group (ED-51 patients) and the IV PCA group (IV-43 patients). The epidural catheter tip was placed one level cephalad to the level of the PLIF in patients in the ED group. Patients were assessed by determining the pain score, cumulative opioid requirement, adverse effects, and satisfaction.
  
  
  
  Pain score comparisons between the ED group and the IV group, respectively, were as follows: immediate postoperative status: 2.1 ± 1.5 vs. 7.2 ± 2.1, p = 0.01; postoperative day 1: 2.3 ± 1.9 vs. 6.8 ± 2.3, p = 0.02; postoperative day 2: 1.9 ± 1.8 vs. 5.4 ± 2.1, p = 0.02; postoperative day 3: 1.5 ± 1.6 vs. 3.9 ± 1.9, p = 0.03; postoperative day 4: 3.8 ± 2.1 vs. 3.1 ± 1.9, p = 0.4. Lower levels of opioids were required in the ED group, and fewer opioid-related complications developed in the patients in this group. Complications related to the use of epidural catheters were comparable between the two groups. Patient satisfaction with postoperative pain control was higher in the ED group.
  
  
  
  In comparison with the use of IV PCA only, continuous epidural infusion of Ropivacaine resulted in lower pain scores and opioid consumption and higher patient satisfaction levels after posterior lumbar interbody fusion.
authors.affiliation: Department of Orthopaedic Surgery, Korea University, College of Medicine, Anam Hospital, 126-1 Anamdong 5ga, Seongbukgu, Seoul, Korea. drspine90@gmail.com.
authors.forename: Si Young
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Howard S
authors.initials: HS
authors.lastname: An
authors.affiliation: Department of Orthopaedic Surgery, Korea University, College of Medicine, Anam Hospital, 126-1 Anamdong 5ga, Seongbukgu, Seoul, Korea.
authors.forename: Soon Hyuck
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Korea University, College of Medicine, Anam Hospital, 126-1 Anamdong 5ga, Seongbukgu, Seoul, Korea.
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Suh
authors.affiliation: Department of Orthopaedic Surgery, Korea University, College of Medicine, Anam Hospital, 126-1 Anamdong 5ga, Seongbukgu, Seoul, Korea.
authors.forename: Jeong Lae
authors.initials: JL
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology, Korea University, College of Medicine, Seoul, Korea.
authors.forename: Seung Joo
authors.initials: SJ
authors.lastname: Yoon
mesh_terms: D000368:Aged; D000577:Amides / Q000627:therapeutic use*; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002408:Catheters, Indwelling; D019299:Decompression, Surgical; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D011446:Prospective Studies; D000077212:Ropivacaine; D013123:Spinal Fusion; D064232:Visual Analog Scale
chemical_list: D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000077212:Ropivacaine
keywords: Epidural catheter; IV PCA; Posterior lumbar interbody fusion; Postoperative pain; Ropivacaine