Literature DB >> 15644759

Postoperative analgesia following surgical correction for adolescent idiopathic scoliosis: a comparison of continuous epidural analgesia and patient-controlled analgesia.

Daniel J Sucato1, Allison Duey-Holtz, Emily Elerson, Fay Safavi.   

Abstract

STUDY
DESIGN: A retrospective comparison of postoperative continuous epidural analgesia and patient-controlled analgesia following surgical treatment for adolescent idiopathic scoliosis.
OBJECTIVES: To compare the safety and efficacy of continuous epidural analgesia and patient-controlled analgesia following adolescent idiopathic scoliosis surgery. SUMMARY OF BACKGROUND DATA: The most commonly used pain management techniques are continuous epidural analgesia and patient-controlled analgesia. However, no large published reports compare them following adolescent idiopathic scoliosis surgery.
METHODS: A review was performed from 1990 to 2001 of patients undergoing primary surgery for adolescent idiopathic scoliosis. Visual analog scale scores were recorded postoperatively at multiple time periods. Adverse effects related to each pain management technique were noted.
RESULTS: The average of all pain scores (1.3 vs. 1.9) (P < 0.0001) and scores at 2, 4, 6, 8, 12, 24, 36, and 48 hours (p < 0.001) was significantly better in the continuous epidural analgesia group when compared to the patient-controlled analgesia group. The range of pain scores (2.3 vs. 2.7) (P < 0.05) and the average maximum score was less in the continuous epidural analgesia group (2.6 vs. 3.2) (P < 0.05). The need to temporarily stop and then restart the pain management (12.3% vs. 7.0%) (P = 0.04) and premature permanent discontinuation (13.1% vs. 0.0%) (P < 0.001) was greater in the continuous epidural analgesia group than the patient-controlled analgesia group. No neurologic injuries occurred.
CONCLUSIONS: Although both continuous epidural analgesia and patient-controlled analgesia provide effective pain control following surgery for adolescent idiopathic scoliosis, patients with continuous epidural analgesia had significantly better pain scores for all time periods, less fluctuations in pain, and lower maximum pain levels during the postoperative period.

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Year:  2005        PMID: 15644759     DOI: 10.1097/01.brs.0000150832.53604.64

Source DB:  PubMed          Journal:  Spine (Phila Pa 1976)        ISSN: 0362-2436            Impact factor:   3.468


  8 in total

1.  Regional anaesthesia and postoperative analgesia techniques for spine surgery - a review.

Authors:  Najoua Mokraï Benyahia; Ann Verster; Vera Saldien; Margaretha Breebaart; Luc Sermeus; Marcel Vercauteren
Journal:  Rom J Anaesth Intensive Care       Date:  2015-04

Review 2.  An Update on Postoperative Opioid Use and Alternative Pain Control Following Spine Surgery.

Authors:  Kevin Berardino; Austin H Carroll; Alicia Kaneb; Matthew D Civilette; William F Sherman; Alan D Kaye
Journal:  Orthop Rev (Pavia)       Date:  2021-06-22

3.  Efficacy of post-operative analgesia after posterior lumbar instrumented fusion for degenerative disc disease: a prospective randomized comparison of epidural catheter and intravenous administration of analgesics.

Authors:  Torsten Kluba; Fabian Hofmann; Sabine Bredanger; Gunnar Blumenstock; Thomas Niemeyer
Journal:  Orthop Rev (Pavia)       Date:  2010-03-20

4.  Postoperative epidural analgesia versus systemic analgesia for thoraco-lumbar spine surgery in children.

Authors:  Joanne Guay; Santhanam Suresh; Sandra Kopp; Rebecca L Johnson
Journal:  Cochrane Database Syst Rev       Date:  2019-01-16

Review 5.  Postoperative pain management in patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis: a narrative review.

Authors:  Hiroyuki Seki; Satoshi Ideno; Taiga Ishihara; Kota Watanabe; Morio Matsumoto; Hiroshi Morisaki
Journal:  Scoliosis Spinal Disord       Date:  2018-09-12

6.  Efficacy of surgeon-directed postoperative local injection with an analgesic mixture in posterior fusion surgery for adolescent idiopathic scoliosis.

Authors:  Hiroto Makino; Shoji Seki; Katsuhiko Kamei; Yasuhito Yahara; Yoshiharu Kawaguchi
Journal:  BMC Musculoskelet Disord       Date:  2022-03-04       Impact factor: 2.362

Review 7.  Intraoperative epidural analgesia for pain relief after lumbar decompressive spine surgery: A systematic review and meta-analysis.

Authors:  Sem M M Hermans; Aniek A G Lantinga-Zee; Kim Rijkers; Henk van Santbrink; Wouter L W van Hemert; Mattheus K Reinders; Daisy M N Hoofwijk; Sander M J van Kuijk; Inez Curfs
Journal:  Brain Spine       Date:  2021-11-12

8.  Postoperative pain management after spinal fusion surgery: an analysis of the efficacy of continuous infusion of local anesthetics.

Authors:  Richard A K Reynolds; Julie E Legakis; Jillian Tweedie; Youngkey Chung; Emily J Ren; Patricia A Bevier; Ronald L Thomas; Suresh T Thomas
Journal:  Global Spine J       Date:  2013-03-02
  8 in total

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