I had a spinal fusion two years ago that worked pretty well. I remember having a great deal of pain after the surgery. I'm scheduled to have another fusion at a different spot in my spine. Is there any way to get around the post-operative pain?

More and more surgeons are using patient-controlled analgesia (PCA). This refers to a special pump that allows the patient to decide when to receive the next dose of pain medication.

Morphine is the most commonly used drug. But a recent study compared using just morphine after spine surgery to using a combination of morphine and an antiinflammatory medication. The antiinflammatory drug used was a special type called cyclooxygenase-2 (COX-2) inhibitors.

COX-2 inhibitors can decrease pain from inflammation without causing increased blood loss during and after surgery. They are frequently used after many other kinds of surgery. This is the first study to combine them with opioids after spine surgery.

The results showed significantly improved pain control in the patients using PCA plus morphine. Overall, they used less pain medication during the first 48-hours after surgery. Pain relief was obtained both at rest and during movement. This helped patients get up, move around, and complete daily self-care tasks in the early post-operative period.

Tell your surgeon about your concerns. Ask if PCA combined with a COX-2 inhibitor is possible. Find out what all your options are for post-operative pain-control before having the surgery.