Postoperative pain following degenerative lumbar spine surgery Degenerative lumbar spine surgery Corticosteroid Postoperative pain Morphine consumption
Conditions
Interventions
Dexamathasone 8 mg intravenously intraoperatively following by Dexamethasone 8 mg intravenously every 8 hours for total of 3 doses, postoperatively,Dexamathasone 8 mg intravenously intraoperatively fo
Experimental Drug,Placebo Comparator Drug
Continuous dexamethasone,Single-dose dexamethasone
Sponsors
Naresuan University
Eligibility
Sex/Gender
All
Age
30 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Patients who are diagnosed with degenerative lumbar spine disease and scheduled to undergo conventional laminectomy with instrumented fusion of 2-5 levels, performed by the spine surgery team and study investigators at Naresuan University Hospital. 2. Patients capable of using patient-controlled analgesia (PCA) and able to report pain intensity using the Numeric Rating Scale (NRS). 3. Patients who are willing to participate in the study and who provide written informed consent.
Exclusion criteria
Exclusion criteria: 1. Presense of diabetes mellitus. 2. History of corticosteroid therapy prior to surgery, defined as a dose equivalent to prednisolone > 5 mg/day for more than 3 weeks before surgery, or > 20 mg/day. 3. Presence of spondylolisthesis greater than 50%, scoliosis greater than 20 degrees, or surgery performed primarily for spinal deformity correction. 4. History of prior spinal surgery at the same or adjacent levels. 5. History of spinal trauma or vertebral compression fracture prior to surgery. 6. History of malignancy involving the spine. 7. History of spinal infection, and the surgery is performed for infection control. 8. History of allergy to paracetamol, tramadol, NSAIDs, gabapentin, or bupivacaine.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Total morphine consumption every 8 hours postoperatively for 48 hours then every 24 hours until discharge Total cumulative morphine consumption (mg), recorded from the patient-controlled analgesia device and nursing records. | — |
Secondary
| Measure | Time frame |
|---|---|
| Rescue medication every 8 hours postoperatively for 48 hours then every 24 hours until discharge Name and frequency of non-opioids rescue analgesic doses administered, recorded by nurses,Numerical rating scale (NRS) every 8 hours postoperatively for 48 hours then every 24 hours until discharge 0-10 Numeric Rating Scale (NRS),Incidence of postoperative nausea and vomiting every 8 hours postoperatively for 48 hours then every 24 hours until discharge Incidence of postoperative nausea and/or vomiting, recorded by nurses,Time to first ambulation during hospitalization Time (hours) from end of surgery to first ambulation, recorded by physical therapists,Blood glucose every 24 hours for 72 hours Capillary blood glucose (mg/dL),C-reactive protein (CRP) every 24 hours for 72 hours Serum CRP level (mg/L),Oswestry Disability Index preoperative, postoperative 2 weeks, 1 months, 3 months Total score (0-100%), standardized questionnaire,Length of hospitalization until discharge Postoperative length of hospital stay (days),Surgical site infection postoperative 2 weeks, 1 months, 3 months Incidence of surgical site infection, assessed by the surgeon | — |
Countries
Thailand
Contacts
Public ContactThanapong Kajhontrideth
Naresuan University Hospital
Outcome results
None listed