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Dual Epidural Analgesia Most Effective for Scoliosis Surgery

WEDNESDAY, Sept. 18 (HealthDay News) -- Dual continuous epidural analgesia (CEA) is the most effective pain control method following surgery for adolescent idiopathic scoliosis, according to a study published in the Sept. 1 issue of Spine.

Joshua W.B. Klatt, MD, from the University of Utah in Salt Lake City, and colleagues randomized 66 patients with adolescent idiopathic scoliosis to patient-controlled analgesia (PCA), single CEA, or double CEA. Analyzed data included postoperative pain scores, side effects, complications, and use of breakthrough medication. Recovery times were assessed by several measurements, including hospitalization, times to first bowel movement, and days to walk and climb stairs.

The researchers found that double CEA most effectively controlled pain intensity, compared to PCA and a single CEA. PCA and single CEA groups similarly controlled pain. Single CEA had the fewest side effects, with an average of 2.55 side effects per patient. Pruritis, constipation, and nausea constituted the majority of side effects. No late onset neurological events were seen in any patients.

"On the basis [of] these findings, we now routinely use the double CEA technique for all patients having surgery for adolescent idiopathic scoliosis," Klatt and colleagues conclude.

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Further Reading
Unexplained pain after the six-month postoperative period occurs in 7 percent of patients undergoing surgery for adolescent idiopathic scoliosis (AIS).
Higher preoperative levels of pain and anxiety may be risk factors for chronic postsurgical pain for patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion, according to a study published in the Feb. 1 issue of Spine.
Adults with idiopathic scoliosis have a higher prevalence of back problems, compared to individuals without scoliosis, according to a study published in the May 15 issue of Spine.
A recent Cochrane review concluded that there is a lack of high-quality evidence on the efficacy of scoliosis-specific exercise (SSE) in adolescents with adolescent idiopathic scoliosis (AIS).
For patients undergoing spinal fusion for adolescent idiopathic scoliosis, low body mass index is associated with greater percent correction of thoracic curves, according to a study published in the Jan. 15 issue of Spine.
Bracing for adolescent idiopathic scoliosis only decreases the risk of progression to surgery when patients are highly compliant with wearing the brace, according to a study published in the April 16 issue of The Journal of Bone & Joint Surgery.
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