Is multimodal or patient-controlled analgesia more effective following an ACDF? 5 observations

Chicago-based Rush University Medical Center researchers compared the use of multimodal analgesia versus patient-controlled analgesia following anterior cervical discectomy and fusion, according to a study published in Spine.

The study involved 239 patients undergoing ACDF, with 55 receiving MMA and 184 receiving PCA. Researchers recorded inpatient narcotic consumption, pain scores, nausea, length of hospital stay and narcotic dependence months following surgery.  

Here are five observations:

1. The patients receiving MMA experienced a lower rate of inpatient narcotic consumption.

2. MMA patients were not as likely to experience nausea during hospitalization, and experienced shorter hospital stays.

3. Researchers did not find discrepancies between the patient groups in mean visual analogue pain scale during postoperative day zero or day one.  

4. The narcotic dependence rate did not differ at the first or second postoperative visits between the two patient groups.  

5. Researchers concluded patients receiving MMA experience lower narcotic consumption than those receiving PCA, following ACDF. However, MMA and PCA seem to offer comparable postoperative analgesia.

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