Abstract
Objective Postoperative pain management following scoliosis surgery has traditionally relied on intravenous opioids. The objective of this study was to evaluate the effect of elastomeric pain pumps.MethodsA retrospective chart review of 81 adolescent patients who underwent scoliosis surgery in a seven-year period was performed. Patients were divided into three groups as the practice changed: (1) patient-controlled analgesia group (12 patients) who used intravenous (IV) opioids with oral opioids; (2) elastomeric pain pump group (28 patients) with the added use of bupivacaine; and (3) multimodal pain pump group (41 patients) with the added use of gabapentin and methocarbamol. Endpoints were analyzed for length of stay in the hospital, infection rate, and gastrointestinal retention.ResultsThe length of stay in the elastomeric pain pump group was 3.1 days shorter than in the patient-controlled analgesia group (P = 0.004). The length of stay in the multimodal group was 3.9 days shorter than in the patient-controlled analgesia group (P = 0.001). The incidence of prolonged postoperative bowel retention decreased significantly from 25% to 18% to 2% (P = 0.03).ConclusionsTo our knowledge, this is the first study on the use of elastomeric pain pumps in conjunction with multimodal pain medication following scoliosis surgery. The use of elastomeric pain pumps was associated with clinically and statistically significant improvements in the postoperative course. The addition of methocarbamol and gabapentin was associated with a trend toward further improvements.
Highlights
Multimodal analgesia has been shown to be effective in reducing opioid use in adult spine and joint arthroplasty patients, but little data is available on multimodal analgesia in adolescentHow to cite this article Kriel H H, Yngve D (February 11, 2019) Elastomeric Pain Pumps for Scoliosis Surgery
Received 01/10/2019 Review began 01/18/2019 Review ended 02/04/2019 Published 02/11/2019. This is the first study on the use of elastomeric pain pumps in conjunction with multimodal pain medication following scoliosis surgery
The results showed a significant difference in the length of stay for the three groups of patients, with the multimodal pain pump (MPP) group having a shorter length of stay (Table 2)
Summary
Multimodal analgesia has been shown to be effective in reducing opioid use in adult spine and joint arthroplasty patients, but little data is available on multimodal analgesia in adolescent. How to cite this article Kriel H H, Yngve D (February 11, 2019) Elastomeric Pain Pumps for Scoliosis Surgery. Postoperative pain management for adolescent scoliosis patients has relied on patient-controlled intravenous and oral opioids. Opioids are associated with side effects that include respiratory depression, pruritus, constipation, nausea, vomiting, and sedation, which can lead to delayed recovery time and patient discomfort. It was hypothesized that the use of elastomeric pain pumps improves the postoperative course of adolescent scoliosis patients
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