AI Article Synopsis
- The study aimed to assess how intraoperative liposomal bupivacaine (LB) affects pain management after surgery in adolescent idiopathic scoliosis (AIS) patients, measuring factors like opioid use, mobility, and hospital stay length.
- 119 AIS patients were divided into two groups: one receiving LB along with standard pain management and the other receiving only standard care, with results showing significantly lower opioid consumption and shorter hospital stays in the LB group.
- Findings indicated that LB led to less opioid use, quicker recovery (discharge on average by postoperative day 2), and better post-surgery ambulation without notable differences in pain scores or nausea.
Article Abstract
Study Design: Retrospective controlled cohort.
Objective: To evaluate the effect of intraoperative liposomal bupivacaine (LB) infiltration on postsurgical pain management in adolescent idiopathic scoliosis (AIS) patients by analyzing postoperative opioid consumption, ambulation, and length of stay (LOS).
Summary Of Background Data: Optimal postoperative pain control for AIS patients undergoing posterior spinal fusion (PSF) is challenging. Multimodal pain management protocols provide adequate analgesia while decreasing opioid consumption. LB was recently approved for pediatric patients; however, use in AIS patients is understudied.
Methods: 119 consecutive patients with AIS who underwent PSF were included. Patients were divided into 2 groups: patients who received LB as erector spinae block in addition to the standard postoperative pain management protocol (Group A), and patients who received only the standard postoperative pain protocol (Group B). Oral morphine equivalents, intravenous opioid and valium consumption, pain scores (VAS), nausea/vomiting, ambulation distance and LOS were assessed.
Results: Group A experienced significantly lower total opioid consumption compared to Group B (44.5 mg vs. 70.2 mg). Morphine use was lower in Group A on postoperative day (POD) 0, and oxycodone use was lower in Group A on PODs 1 and 2. There was a higher proportion of patients who used only oral opioids in Group A (81% vs. 41%). Of patients requiring any intravenous opioids, 79% did not receive LB. A significantly higher proportion of LB patients were discharged on POD 2 (55% vs. 27%); therefore, LOS was shorter for Group A. Group A ambulated further postoperatively. There were no differences in pain scores, valium requirements or nausea/vomiting.
Conclusions: LB was associated with decreased total opioid use, shorter LOS, and improved ambulation in AIS patients undergoing PSF. Including LB in multimodal pain management protocols proved effective in reducing opioid use while increasing mobilization in the immediate postoperative period.
Level Of Evidence: 3.
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| http://dx.doi.org/10.1097/BRS.0000000000004702 | DOI Listing |
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