Abstract
Spinal deformity corrections in paediatric patients are long-lasting procedures involving damage to many tissues and long pain exposure; therefore, effective pain management after surgical treatment is an important issue. In this study, the effect of inclusion of local infiltration analgesia, as an integral part of the scheme in postoperative pain control, in children and adolescents, subjected to the spinal deformity correction procedure, was assessed. Thirty patients, aged 8 to 17 years, undergoing spinal deformity correction were divided into a study group, receiving a 0.25% bupivacaine solution before wound closure, and a control group (no local analgesic agent). Morphine, at the doses of 0.10 mg/kg of body weight, was administered to the patients when pain occurred. Pain scores, morphine administration, and bleeding were observed during 48 postoperative hours. The pain scores were slightly lower in a 0–4 h period in patients who received bupivacaine compared with those in the control group. However, no differences were observed in a longer period of time and in the total opioid consumption. Moreover, increasing bleeding was observed in the bupivacaine-treated patients (study group) vs. the control. Bupivacaine only modestly affects analgesia and, due to the increased bleeding observed, it should not to be part of pain control management in young patients after spinal deformity correction.
Highlights
0.1%. of paediatric patients suffering from scoliosis need surgical treatment; posterior spinal deformity corrections are long-lasting procedures, which require an extensive surgical approach, involving damage to many tissues and long pain exposure
This study aimed to assess the effectiveness of local injections of bupivacaine as part of postoperative analgesia in children undergoing surgical corrections due to spinal deformities
The investigation showed that the pain sensation was moderately reduced up to 4 h after the surgery in patients treated with bupivacaine; the study and control groups did not differ significantly in the time up to the first morphine administration in the ward and in the total amount of opiates administered during 48 h
Summary
Of paediatric patients suffering from scoliosis need surgical treatment; posterior spinal deformity corrections are long-lasting procedures, which require an extensive surgical approach, involving damage to many tissues and long pain exposure. They carry the risk of many problems and complications [1,2]. Effective pain management after posterior spinal fusion, in paediatric patients, is an essential part of surgical treatment for increasing patient’s comfort, allowing quicker convalescence It decreases the risk of complications, such as perioperative myocardial ischaemia, respiratory complications, immunological disorders, and postoperative cognitive disorders [5,6]. Pharmacological treatment, including opioids, is regarded as the most effective; according to the WHO recommendation, reduction in drug administration is recently encouraged, due to the risk of adverse effects in patients [7]
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