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

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

Research output: Contribution to journalArticle

39 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)211-217
Number of pages7
JournalSpine
Volume30
Issue number2
DOIs
StatePublished - Jan 15 2005

Fingerprint

Patient-Controlled Analgesia
Epidural Analgesia
Scoliosis
Analgesia
Pain
Pain Management
Nervous System Trauma
Visual Analog Scale
Postoperative Period
Safety

Keywords

  • Adolescent idiopathic scoliosis
  • Epidural analgesia
  • Patient-controlled analgesia

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Postoperative analgesia following surgical correction for adolescent idiopathic scoliosis : A comparison of continuous epidural analgesia and patient-controlled analgesia. / Sucato, Daniel J.; Duey-Holtz, Allison; Elerson, Emily; Safavi, Fay.

In: Spine, Vol. 30, No. 2, 15.01.2005, p. 211-217.

Research output: Contribution to journalArticle

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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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