Epidural Analgesia Compared With Intravenous Analgesia After Pediatric Posterior Spinal Fusion

Abstract

Level 2, randomized, controlled trial.

Comparison of pain relief between patient-controlled epidural analgesia and patient-controlled intravenous analgesia for patients undergoing spinal fusion surgeries

“…However, there are also complications of spinal fusion that mainly include wound complications, major medical complications which comprises procedure codes for endotracheal intubation, cardiopulmonary resuscitation, as well as mechanical ventilation, and mortality [9]. Additionally, during the spinal fusion, analgesia scheme such as patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (PCIA) are also of importance to relieve the pain of patients [10][11][12].…”

“…Besides, PCEA can relieve postoperative stress as well as can offer a fast recovery of intestinal activity after operations [26]. It was well-known that both PCEA and PCIA are applicable to the analgesia of spinal fusion, while there remains a controversy for the optimal method for the postoperative pain relief [12,27]. Recently, several previous studies have indicated that PCEA is more effective than PCIA for the analgesia of spinal fusion [28][29][30][31].…”

Regional Analgesia Techniques for Spine Surgery: A Review with Special Reference to Scoliosis Fusion

“…Other advantages were less side-effects such as nausea/vomiting [9,34,41,53,55], faster return of bowel function and oral intake [23, 48,54], faster ambulation [52], enhanced patient satisfaction and in a few studies faster hospital discharge [21].…”

“…Some authors found that due to the frequent side-effects the epidural route could not be recommended as first line treatment for postoperative analgesia after spine surgery [24, 35,47], while more patients suffered paresthesia with placement of the catheter [25][26][27]. Failure of the epidural modality, need for temporarily or permanent discontinuation of epidural treatment and/or catheter loss while costing significantly more than systemic analgesia were additional reasons for less enthousiasm in certain studies [20,29,34].…”

“…With respect to scoliosis surgery most comparative studies found epidural analgesia to be extremely beneficial [21,29,34,36,[63][64][65][66][67]. Only three studies [21,23,26] found no differences in pain scores although Van Boerum et al noticed faster bowel recovery and hospital discharge times [21].…”