Murata Shizumasa, Iwahashi Hiroki, Mera Yoshimasa, Shitahodo Toshiya, Inoue Shingo, Kawamura Kota, Kadono Aozora, Murai Kusushi, Hayashi Taiki, Kitano Yoji, Yamada Hiroshi
Department of Orthopedic Surgery, Shingu Municipal Medical Center, 18-7 Hachibuse, Shingu City, Wakayama, 647-0072, Japan.
Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan.
Eur Spine J. 2025 Jan;34(1):301-307. doi: 10.1007/s00586-024-08512-2. Epub 2024 Oct 6.
This study aimed to evaluate the analgesic effects and safety of multidrug cocktail injections for postoperative pain management in patients undergoing lumbar microendoscopic decompression surgery.
A prospective randomized controlled trial was conducted with 70 patients who underwent lumbar microendoscopic decompression surgery between December 2023 and May 2024. Patients were randomly assigned to receive either a multidrug cocktail injection (cocktail group, n = 35) or no cocktail injection (non-cocktail group, n = 35). Primary outcomes included scores of the numerical rating scale (NRS) for pain from postoperative days 1 to 7 and the number of analgesics used within the first 3 postoperative days. Secondary outcomes included sex, age, body mass index, preoperative diagnosis, surgical levels, duration of surgery, blood loss, C-reactive protein (CRP) levels on postoperative day 1, and drain output.
The cocktail group experienced significantly lower pain levels from postoperative days 1 to 7 (p < 0.05) and used fewer analgesics within the first 3 days (p = 0.01) compared with the non-cocktail group. Additionally, the cocktail group had significantly lower CRP levels (p < 0.001) and a shorter hospital stay (p = 0.01). No significant differences were observed in the duration of surgery, blood loss, or drain output between the groups.
Multidrug cocktail injections are effective and safe for postoperative pain management in lumbar microendoscopic decompression surgery, significantly reducing pain, analgesic use, CRP levels, and hospital stay. These findings suggest that incorporating multidrug cocktail injections into postoperative care protocols can enhance patient recovery and outcomes.
本研究旨在评估多药联合注射用于腰椎显微内镜减压手术患者术后疼痛管理的镇痛效果及安全性。
对2023年12月至2024年5月期间接受腰椎显微内镜减压手术的70例患者进行了一项前瞻性随机对照试验。患者被随机分配接受多药联合注射（联合组，n = 35）或不接受联合注射（非联合组，n = 35）。主要结局包括术后第1至7天疼痛的数字评分量表（NRS）得分以及术后前3天使用的镇痛药数量。次要结局包括性别、年龄、体重指数、术前诊断、手术节段、手术时长、失血量、术后第1天的C反应蛋白（CRP）水平以及引流量。
与非联合组相比，联合组在术后第1至7天的疼痛水平显著更低（p < 0.05），且在术后前3天使用的镇痛药更少（p = 0.01）。此外，联合组的CRP水平显著更低（p < 0.001），住院时间更短（p = 0.01）。两组之间在手术时长、失血量或引流量方面未观察到显著差异。
多药联合注射用于腰椎显微内镜减压手术的术后疼痛管理是有效且安全的，可显著减轻疼痛、减少镇痛药使用、降低CRP水平并缩短住院时间。这些发现表明，将多药联合注射纳入术后护理方案可促进患者康复并改善结局。
