Abstract
Background context: Epidural analgesia has been demonstrated to be effective in managing post-operative pain across many surgical procedures including posterior spinal instrumented fusion. Since the inception of our paediatric orthopaedic spinal unit in 2015, continuous epidural analgesia has been provided to all posterior spinal instrumented fusion patients. This study presents data validating the safety and utility of continuous epidural analgesia.
Purpose: The study was set out to assess the safety and utility of continuous epidural analgesia used for post-operative pain control after all posterior spinal instrumented fusion for adolescent idiopathic scoliosis. Quantitative metrics known to relate to analgesic safety and post-operative recovery were selected for review.
Study Design: A retrospective clinical study of 83 patients was conducted via electronic medical chart review of records from 06/01/2020 to 19/12/2022 from this centre.
Methods: Data regarding the perioperative recovery and side effects of this group (i.e. days to mobilisation, first bowel motion, return to full diet and length of hospital stay) were compared to those who had no change to their neurological examination. Statistical analysis was performed using student’s T-test and logistic regression modelling, using SPSS1.
Results: Fifty-seven patients (68%) experienced no change of their neurological examination, whilst 26 patients (32%) did, while undergoing epidural analgesia. Time to achieve post-operative outcomes was similar between groups. Occurrence of a temporary neurological change did not relate to higher rates of secondary complications.
Conclusion: The association of temporary neurological changes with the use of continuous epidural analgesia for control of post-operative pain following posterior spinal instrumented fusion does not impede the attainment of post-operative milestones, nor do they elevate the risk of secondary complications.