Preemptive Pain Management May Reduce Postsurgical Discomfort

Preemptive analgesia to manage pain before spinal surgery may lead to less pain after surgery, according to the results of a study published in the May/June 2013 issue of Pain Physician.

The prospective, observational study included 393 patients, ranging in age from 21 to 91 years, who were treated at 17 hospitals. All participants underwent spinal surgery for degenerative spine disease and completed questionnaires on their pain management protocols after surgery.

Before surgery, 20% of patients received preemptive analgesics, including COX-2 inhibitors, at the time of antibiotic prophylaxis. After surgery, pain was managed by multimodal therapy and combinations of patient-controlled anesthesia, NSAIDs, COX-2 inhibitors, and narcotics in 92% of patients.

Pain levels did not vary among patients receiving different regimens of post-operative pain management, but were significantly different depending on whether patients received preemptive pain management. Patients who did not receive preemptive analgesia were more likely to report postoperative self-administration of anesthesia than those who received preemptive analgesia. Two weeks after surgery, patients who had received preemptive pain management experienced less depression and anxiety and were better able to take care of themselves and participate in usual activities than those who had received no preemptive management.