الفهرس 
Physiology of PainOnly 14 pages are availabe for public view
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Abstract
Background: Postoperative pain after spine surgeries is a major concern for the patient, anesthesiologists and surgeons. Nociceptive signals have the capacity to initiate prolonged changes in both the peripheral and central nervous system that will lead to the amplification and prolongation of postoperative pain.
Objective: This study aims to compare between the effect of MMA and single mode analgesia in lumber spine surgery on intraoperative and early postoperative analgesia, the consumption of morphine in both types and incidence of side effects.
Patients and Methods: In our study a number of 70 patients were scheduled to undergo single or double lumber vertebral discectomy or fixation under general anesthesia and were randomly assigned to one of two groups: group A: (35 patients) The multimodal group that received preoperative analgesia in the form of paracetamol 1 gm I.V, Ketorolac 30 mg and morphine 3 mg I.V. 20-30- min before surgery and intraoperative maintenance of analgesia for this group was done by morphine I.V> infusion in a rate of 1mg/hour. group B (35 patients) The single mode group that received preoperative analgesia in the form of morphine 3m I.V 20-30 min before surgery only. Intraoperative maintenance of analgesia for this group was done by morphine I.V. infusion at a rate of 1 mg/hour.
Results: Regarding systolic and diastolic blood pressure and heart rate, there was a significant decrease in intraoperative and early postoperative values in the multimodal group than morphine group. Regarding narcotic consumption there was significant lower consumption in the multimodal group and also significant longer interval time for requesting analgesia.
Conclusion: we conclude that the use of MMA prolonged the duration of postoperative analgesia and decrease the intensity of pain, with stable hemodynamics and without any respiratory burden, furthermore it decrease the consumption of narcotics by decreasing the frequent requesting of analgesia.