Current Trends in Pediatric Spine Deformity Surgery: Multimodal Pain Management and Rapid Recovery

Overview

Journal Global Spine J

Publisher Sage Publications

Date 2020 Apr 22

PMID 32313800

Citations 11

Authors

Sagar A Shah

Richard Guidry

Abhishek Kumar

Tyler White

Andrew King

Michael J Heffernan

Affiliations

Soon will be listed here.

Abstract

Study Design: Narrative review.

Objectives: The purpose of this article is to perform a review of the literature assessing the efficacy of opioid alternatives, multimodal pain regimens, and rapid recovery in pediatric spine surgery.

Methods: A literature search utilizing PubMed database was performed. Relevant studies from all the evidence levels have been included. Recommendations to decrease postoperative pain and expedite recovery after posterior spinal fusion in adolescent idiopathic scoliosis patients have been provided based on results of studies with the highest level of evidence.

Results: Refining perioperative pain management to lessen opioid consumption with multimodal regimens may be useful to decrease recovery time, pain, and complications. Nonsteroidal anti-inflammatory drugs, acetaminophen, gabapentin, neuraxial blockades, and local anesthesia alone offer benefits for postoperative pain management, but their combination in multimodal regimens and rapid recovery pathways may contribute to faster recovery time, improved pain levels, and lower reduction in total opioid consumption.

Conclusion: A rapid recovery pathway using the multimodal approach for pediatric scoliosis correction may offer superior postoperative pain management and faster recovery than traditional opioid only pain protocols.

Citing Articles

Intravenous lidocaine infusion therapy and intraoperative neurophysiological monitoring in adolescents undergoing idiopathic scoliosis correction: A retrospective study.

Bates R, Cave F, West N, Bone J, Hofmann B, Miyanji F Paediatr Anaesth. 2024; 35(1):47-56.

PMID: 39367703 PMC: 11626343. DOI: 10.1111/pan.15019.

Comparison of the effects of submucosal hyaluronidase and dexamethasone on postoperative edema, pain, trismus, and infection following impacted third molar surgery.

Koc O, Er N, Karaca C, Bilginaylar K BMC Oral Health. 2024; 24(1):1018.

PMID: 39215323 PMC: 11365265. DOI: 10.1186/s12903-024-04729-1.

Adoption of an Enhanced Recovery after Surgery Protocol for Neuromuscular Scoliosis Shortens Length of Hospital Stay.

Nakamura N, Kawabe Y, Momose T, Oba M, Yamamoto K, Takamasu T Spine Surg Relat Res. 2024; 8(4):427-432.

PMID: 39131418 PMC: 11310540. DOI: 10.22603/ssrr.2023-0193.

Utilization of individual components of enhanced recovery after surgery (ERAS) protocol improves post-operative outcomes in adolescent idiopathic scoliosis: a blueprint for progressive adoption of ERAS.

Lebel D, Machida M, Koucheki R, Campbell F, Bath N, Koyle M Spine Deform. 2023; 11(5):1117-1125.

PMID: 37233951 PMC: 10425294. DOI: 10.1007/s43390-023-00706-w.

Perioperative gabapentin usage in pediatric patients: A scoping review.

Chen O, Cadwell J, Matsoukas K, Hagen J, Afonso A Paediatr Anaesth. 2023; 33(8):598-608.

PMID: 37073498 PMC: 10464522. DOI: 10.1111/pan.14674.

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