Show Summary Details
Page of

Complex Spine 

Complex Spine
Complex Spine

David A. Edwards

, and Christopher Sobey

Page of

PRINTED FROM OXFORD MEDICINE ONLINE ( © Oxford University Press, 2022. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 05 July 2022

Patients undergoing extensive spine surgery suffer from significant pain throughout the perioperative period. Of note, many patients utilize opioid medications preoperatively, which increases the risk of postoperative pain and numerous other risks. This chapter describes how central sensitization plays an essential role throughout the perioperative period and should be considered when planning tailored analgesic regimens. The chapter also details how NMDA antagonists such as ketamine can be used in the postoperative setting to reduce pain intensity and decrease opioid use. It concludes with a discussion of how the risk of opioid-induced ventilatory impairment can be managed postoperatively, including with nursing evaluation for somnolence and sedation at regular intervals in the first 4 hours after discharge from the postanesthesia care unit.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.