The Effect of Epidural Low-Dose Morphine-Soaked Microfibrillar Collagen Sponge in Postoperative Pain Control after Laminectomy and Instrumented Fusion: A Randomized Double-Blind Placebo-Controlled Study
Sirichai Wilartratsami MD*, Vimolluck Sanansilp MD**, Thanase Ariyawatkul MD*, Chatupon Chotigavanichaya MD*, Witchate Pichaisak MD*, Areesak Chotivichit MD*, Panya Luksanapruksa MD*
Affiliation : * Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand **Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To evaluate the postoperative analgesic effect and postoperative nausea and vomiting (PONV) after using epidural
low-dose morphine-soaked microfibrillar collagen sponge (MMCS), as compared with placebo.
Material and Method: A prospective randomized double-blind placebo-controlled study was performed on patients under-
going single-level posterior lumbar spinal decompression and instrumented fusion at the Department of Orthopedic Surgery,
Siriraj Hospital, between August 2012 and December 2013. Patients were randomly allocated into two groups to receive
either an epidural MMCS or an epidural normal saline-soaked microfibrillar collagen sponge (placebo). Intensity of pain,
PONV, and total amount of morphine were recorded at 4, 24, 48, and 72 hours, postoperatively.
Results : The analgesic effect was enhanced significantly in the epidural MMCS group, as the amount of morphine used was
statistically less than in the placebo group at 4 and 24 hours (p<0.05).
Conclusion : A single low-dose epidural MMCS is effective for pain control after posterior lumbar spinal surgery with a low
incidence of PONV.
Keywords : Epidural morphine, Randomized controlled trial, Pain after spinal surgery, Microfibrillar collagen sponge
