title: Use of a double epidural catheter provides effective postoperative analgesia after spine deformity surgery.
abstract: OBJECTIVE
  Spine deformity surgery is a painful procedure in which pain control is difficult to obtain. The aim of this study was to evaluate the efficacy of double epidural catheters in this setting.
  
  
  METHODS
  Twenty-three patients scheduled for an elective spine deformity surgery were included prospectively. At the end of surgery, the surgeon inserted two epidural catheters, one cranial, one caudal to the surgical field. In the recovery room the catheters were both injected with a bolus of bupivacaine 0.0625%. In the absence of any neurological abnormality a continuous infusion of bupivacaine 0.0625%, fentanyl 2 microg.mL(-1) and clonidine 3 microg.mL(-1) was administered at a rate of 10 mL.hr(-1) through each catheter for 48 hr. Pain score, sedation level, motor block and side-effects were checked regularly.
  
  
  RESULTS
  Complete analgesia (VAS=0) was obtained at rest in all patients. During mobilization and physiotherapy four patients (17%) had a VAS 30. No motor block was observed. Four patients (17%) had nausea and vomiting. No excessive sedation, pruritus or respiratory depression were observed. Early mobilization was possible in all patients.
  
  
  CONCLUSIONS
  Postoperative epidural analgesia by means of a double catheter is an effective technique to control pain after spine deformity surgery and is associated with a low incidence of side-effects.
authors.affiliation: Departments of Anesthesiology, and Orthopedic Surgery, Orthopedic University Hospital Zurich/Balgrist, Zurich, Switzerland.
authors.forename: Georgios
authors.initials: G
authors.lastname: Ekatodramis
authors.forename: Kan
authors.initials: K
authors.lastname: Min
authors.forename: Philipp
authors.initials: P
authors.lastname: Cathrein
authors.forename: Alain
authors.initials: A
authors.lastname: Borgeat
mesh_terms: D000293:Adolescent; D000328:Adult; D015360:Analgesia, Epidural / Q000295:instrumentation*; D002404:Catheterization; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D013131:Spine / Q000002:abnormalities* / Q000601:surgery*