RT Journal Article
SR Electronic
T1 A Randomized Comparison of the Effects of Continuous Thoracic Epidural Analgesia and Intravenous Patient-Controlled Analgesia After Posterior Spinal Fusion in Adolescents
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP 246
OP 253
DO 10.1053/xr.2000.5661
VO 25
IS 3
A1 Joseph F. Cassady, Jr.,
A1 George Lederhaas
A1 Dawn D. Cancel
A1 R. Jay Cummings
A1 Eric A. Loveless
YR 2000
UL http://rapm.bmj.com/content/25/3/246.abstract
AB Background and Objectives Pain and gastrointestinal dysfunction are primary factors that delay recovery after posterior spinal fusion. Previous reports suggest that the choice of analgesic management may effect the course of recovery. This prospective, randomized study compared continuous thoracic epidural analgesia and patientcontrolled analgesia in the postoperative care of adolescents undergoing posterior spinal fusion for idiopathic scoliosis.Methods Patients between 11 and 18 years of age were randomized to receive continuous thoracic epidural analgesia with bupivacaine-fentanyl (CEA, n = 17) or intravenous patient-controlled analgesia with morphine sulfate (n = 16). After surgery under general anesthesia, pain intensity was evaluated using a self-report visual analog scale (VAS). Postoperative time to resumption of bowel sounds, liquid intake, and side effects were also recorded.Results There were no significant differences between groups in VAS pain scores, side effects, or time to resumption of liquid intake. There was a significant difference (P = .0089) between groups in return of bowel sounds, which occurred earlier in patients receiving CEA.Conclusions Continuous epidural analgesia and patient-controlled analgesia are comparably effective and safe after posterior spinal fusion. Return of bowel sounds occurred significantly more rapidly in patients receiving CEA postoperatively.