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Postoperative pain management following scoliosis surgery


Borgeat, A; Blumenthal, S (2008). Postoperative pain management following scoliosis surgery. Current Opinion in Anaesthesiology, 21(3):313-316.

Abstract

PURPOSE OF REVIEW: The control of pain after scoliosis surgery is a real challenge for the anesthesiologist. The first reason is that major spine surgery for correction of scoliosis deformation causes severe postoperative pain, and second that patients undergoing these operations are most often children or adolescents who are known to suffer from increased pain sensation compared with adults. RECENT FINDINGS: A multimodal postoperative pain therapy is a well established procedure to control the pain after scoliosis surgery. Recently, prospective, well controlled studies have emphasized the key role of regional techniques in this context. Epidural analgesia has shown significant benefits regarding pain score, bowel recovery and patients' satisfaction. However, different modes of epidural analgesia application have been performed. Several issues including local anaesthetic concentration and infusion rate, duration of application and number of catheters placed will be discussed. The safety concerns associated with this type of analgesia will also be emphasized. SUMMARY: Significant improvements have been made in the control of postoperative pain after correction of scoliosis deformation in recent years. The introduction of epidural analgesia has cleared the way for better analgesic techniques in this surgical context. Properly performed and assessed, the addition of epidural analgesia after scoliosis surgery is a safe and effective form of analgesia and the benefits far outweigh the risks.

Abstract

PURPOSE OF REVIEW: The control of pain after scoliosis surgery is a real challenge for the anesthesiologist. The first reason is that major spine surgery for correction of scoliosis deformation causes severe postoperative pain, and second that patients undergoing these operations are most often children or adolescents who are known to suffer from increased pain sensation compared with adults. RECENT FINDINGS: A multimodal postoperative pain therapy is a well established procedure to control the pain after scoliosis surgery. Recently, prospective, well controlled studies have emphasized the key role of regional techniques in this context. Epidural analgesia has shown significant benefits regarding pain score, bowel recovery and patients' satisfaction. However, different modes of epidural analgesia application have been performed. Several issues including local anaesthetic concentration and infusion rate, duration of application and number of catheters placed will be discussed. The safety concerns associated with this type of analgesia will also be emphasized. SUMMARY: Significant improvements have been made in the control of postoperative pain after correction of scoliosis deformation in recent years. The introduction of epidural analgesia has cleared the way for better analgesic techniques in this surgical context. Properly performed and assessed, the addition of epidural analgesia after scoliosis surgery is a safe and effective form of analgesia and the benefits far outweigh the risks.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2008
Deposited On:23 Jan 2009 12:47
Last Modified:06 Dec 2017 17:16
Publisher:Lippincott Wiliams & Wilkins
ISSN:0952-7907
Publisher DOI:https://doi.org/10.1097/ACO.0b013e3282f82baa
PubMed ID:18458547

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