Prospective randomized appraisal of the best pain relief option after L4/L5 discectomy.

Objectives: To determine the efficacy of paracetamol and tramadol analgesia via patient controlled pump and intermittent administration using the Short-Form McGill Pain Questionnaire after L4/L5 discectomy in neurosurgical patients.

Methods: Fourteen months prospective quantitative study with 200 neurosurgical patients' participation who underwent elective discectomy of the L4/L5 intervertebral disc extrusion. The study was conducted due to a patient-controlled analgesia pump and intermittent analgesia application. Pain was assessed using the Short-Form McGill Pain Questionnaire in the Croatian language during the zero, first, and second postoperative day.

Results: Perception of pain was reduced in patient controlled analgesia pump groups after the second measurement during the first postoperative day [95% CI: -3.89, -0.76], regardless of administered analgesic (< 0.001). After the final measurement, at 7 PM on the second postoperative day, the differences were not significant (= 0.070). This study results are registered and allocated in the Australian New Zealand Clinical Trials Registry (ANZCTR).

Discussion: Analgesia administration via patient-controlled pump contributes to the alleviation of postoperative pain after L4/L5 disc extrusion surgery regardless of administered analgesic.