Spinal fusion recovery is improved with pre-induction use of ketamine and clonidine

Acute postoperative pain is a disagreeable sensation related to tissue harm created during a surgical intervention, and is considered a major source of morbidity in patients already weakened by the underlying disease. For that, postoperative pain should be considered seriously, not exclusively because of how disagreeable it is, but also because, if deficiently managed, there is a possibility for the progression to chronic pain and its incumbent morbidity (Rathmell et al., 2006). Consequently, intentional actions should be taken to prophylactic ally treat the pain. The attitude towards pain management after surgeries evolved drastically over the years. The previous attitude consisted of using single drug therapy, which wasn’t as efficient as the newer method: multimodal analgesia. In fact, previously, opioids and NSAIDs were predominantly used, but these drugs were found to have an increasing incidence of undesirable effects with increasing doses. Kehlet and Dahl were the first to propose that associating drugs that act through different mechanisms decreases doses of analgesics, suppresses pain more efficiently, and leads to lower incidence of side effects (Kehlet, 1993). Furthermore, pain is one of the main postoperative unfavorable effects, especially in major spine surgery. Spinal fusion, in particular, is known to be on the top of the list of surgeries causing acute postoperative pain. The aim of this study is to apply the multimodal analgesia in this type of surgery for the purpose of obtaining an ultimate outcome. Ketamine, an N-methyl –D– aspartate receptor antagonist, possesses an analgesic effect in the control of postoperative pain (Blaudszun, 2012). Identically, clonidine, a α2-adrenergic agonist, owns a pain remover property, consequently intensifying postoperative analgesia (Woolf, 1991).