Zhang Hanwen,Liu Haonan,Li Duoyi,et al.Perioperative multimodal analgesia in children with congenital spinal deformities[J].Journal of Clinical Pediatric Surgery,,():1051-1055.[doi:10.3760/cma.j.cn101785-202206030-011]
Perioperative multimodal analgesia in children with congenital spinal deformities
- Keywords:
- Analgesia; Spinal Deformity; Surgical Procedures; Operative; Child
- Abstract:
- Objective To evaluate the effectiveness of perioperative multimodal analgesia regimen in pain management for children with congenital spinal deformities (CSD) and summarize the relevant clinical experiences. Methods For this prospective study,the clinical data were retrospectively reviewed for 80 CSD children undergoing posterior spinal osteotomy,corrective fusion and internal fixation from September 2020 to May 2021.The cohort consisted of 27 boys and 53 girls with a mean age of (6.53±3.03) year and an ASA grade of 2(1,2).They were randomized into two groups of experimental (n=40) and control (n=40).Experimental group received a multimodal analgesia cpmbining preemptive analgesia,postoperative local infiltration anesthesia,and postoperative analgesic dosing.Control group was managed with traditional perioperative pain-relieving.Pain scores were recorded at pre-operation,6h post-operation and postoperative days 1-3 at 9:00 AM,3:00 PM and 8:00 PM.Outcomes,including pain scores,total hospitalization stay,postoperative hospitalization stay and complication rates were compared between two groups. Results All operations were successfully completed without preoperative deformity-related pain.Pain scores for both groups declined over the first three postoperative days.Experimental group had significantly lower scores as compared with control group.At post-operation Day 2/3,pain fluctuations were more pronounced in control group.At Day 3,12 children (30%) in experimental group and 35 cases (87.5%) in control group had pain scores >3.There was statistically significant difference (P<0.001).The incidence of complications was 2.5% (n=2) in experimental group and 15.0% (n=6) in control group.There was no statistically significant difference (P=0.263).The most common complications were mild abdominal pain or bloating in both groups.Total hospitalization stay for experimental and control groups was (13.05±2.81) and (14.70±2.51) day while postoperative hospital stay (6.33±0.80) and (6.90±1.30) day.There were statistically significant differences (P<0.05). Conclusions Using a multimodal analgesia regimen in perioperative management of CSD children may effectively alleviate pain,shorten hospitalization stay and accelerate postoperative recovery.Wider clinical popularization is worthwhile.
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Memo
收稿日期:2023-6-13。
基金项目:新疆维吾尔自治区重点研发任务专项项目(2023B03018—2)
通讯作者:姚子明,Email:docyao@mail.ccmu.edu.cn