Postoperative pain management after spinal fusion surgery: an analysis of the efficacy of continuous infusion of local anesthetics.
Spinal fusion surgery is a major surgery that results in severe postoperative pain, therefore pain reduction is a primary concern. New strategies for pain management are currently under investigation and include multimodal treatment. A 3-year retrospective analysis of patients with idiopathic scoliosis undergoing spinal fusion surgery was performed at our hospital, assessing patient pain scores, opioid use, and recovery. We evaluated the effect of adding continuous infusion of local anesthetics (CILA) to a postoperative pain management protocol that includes intraoperative intrathecal morphine, as well as postoperative patient-controlled analgesia and oral opioid/acetaminophen combination. The study compared 25 patients treated according to the standard protocol, with 62 patients treated with CILA in addition to the pain management protocol. Patients in the CILA group used nearly 0.5 mg/kg less opioid analgesics during the first 24 hours after surgery.
Department of Orthopaedic Surgery, Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan.
Richard A K
RA
Reynolds
Department of Orthopaedic Surgery, Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan.
Julie E
JE
Legakis
Department of Anesthesiology, Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan.
Jillian
J
Tweedie
Wayne State University School of Medicine, Richard J. Mazurek Medical Education Commons, Detroit, Michigan.
Youngkey
Y
Chung
Department of Orthopaedic Surgery, University of Minnesota, Minneapolis.
Emily J
EJ
Ren
Department of Anesthesiology, Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan.
Patricia A
PA
Bevier
Department of Clinical Pharmacology, Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan.
Ronald L
RL
Thomas
Department of Anesthesiology, Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan.
Suresh T
ST
Thomas
continuous infusion of local anesthetics; idiopathic scoliosis; post-operative pain management; spinal fusion