Procjena analgezije opioidima i neopioidima intermitentnom primjenom i samostalna kontrola pumpom nakon lumbalne diskektomije [Opioid and nonopioid analgesia assessment through intermittent application and patient controlled analgesia pump after lumbar discectomy]

Abstract

Low back pain is one of the leading cause of disabilty in an adult, working-active population representing a serious socioeconomic problem. Lumbar discectomy is the gold standard in symptomatic herniated disk treatment. Despite the advances in medicine, pharmacology and technology, postoperative pain frequency is still high. Hypothesis of this disertation is that opioid analgesia delivered by patient controlled pump is more effective in pain reduction compared to opioid intermittent analgesia and nonopioid analgesia after lumbar discectomy. The objectives were to determine the efficacy of two analgesics applied in different ways comparing the most effective method of analgesia. The study included 200 patients treated at the Department of Neurosurgery Sestre milosrdnice Clinical Hospital Center, during 14 months period. The scientific contribution of prospective, randomized clinical study is statistically significant difference of achieving analgesia after lumbar discectomy by patient controlled pump versus intermittent analgesia. No statistically significant differences were found by comparing types of used drugs. Based on the results obtained, it can be concluded that analgesia delivered by patient controlled pump will significantly contribute to postoperative pain reduction. Therefore it could be recommended introducing patient controlled pump as a standard in order to achieve more effective analgesia regardless of applied analgesic