What modalities exist for pain relief after spine surgery?

What modalities exist for pain relief after spine surgery?

Postoperatively, patients are expected to emerge from anesthesia for neurologic evaluation. Adequate pain man-agement is required to prevent hypoventilation or atelectasis and allow for early movement and rehabilitation. Opioid administration begins in the operating room, prior to emergence. Postoperative care is administered along clinical pathways and individualized for each patient. Patient-controlled analgesia (PCA) pumps are routinely used for 1–3 days, after which patients are switched to oral agents. Epidural or intrathecal administration of opioids is also an alternative, particularly in patients with high opioid toler-ance. The epidural catheter may be placed by the anesthe-siologist preoperatively or by the surgeon intraoperatively under direct vision. Communication with staff and the pain service consultant is essential to assure a safe post-operative course. Multimodal therapy involving opioids and nonsteroidal anti-inflammatory agents is an option for certain patients.