Postoperative epidural analgesia versus systemic analgesia for thoraco-lumbar spine surgery in children

Postoperative epidural analgesia versus systemic analgesia for thoraco-lumbar spine surgery in children

“…For time-to-event data (time to return of gastrointestinal transit, time to first mobilization), we contacted trial authors to try to obtain data as hazard ratios (HRs) for analysis but this proved impossible due to no response from some study authors and unavailability of data in this format for others. As planned in the published protocol (Guay 2017), as an alternative solution, we then analysed these data in the format provided by trial authors in their reports and treated them as other continuous data reported as MDs with 95% CIs. When there was an e ect noted, we calculated from the odds ratio a number needed to treat for an additional beneficial outcome (NNTB), or a number needed to treat for an additional harmful outcome (NNTH) (Cates 2016;Deeks 2002).…”

“…We included only parallel-group trials. If a study contained more than two groups, we fused the two groups (by using the appropriate formula for adding SDs when required), when we thought they were equivalent according to the criteria of our protocol (taking our factors for heterogeneity exploration into account), or we separated them and split the control group in half if we thought they were di erent (Guay 2017).…”

“…We would like to thank Javier Eslava-Schmalbach's (Content Editor); and Vaughan L Thomas, Ewan D McNicol, and Nayan K Desai (Peer Reviewers) for help and editorial advice provided during preparation of the protocol for the systematic review (Guay 2017). We would also like to thank the following Cochrane Anaesthesia Critical and Emergency Care editors who screened the dra protocol: Bronagh Blackwood, Jane Cracknell, Harald Herkner, Nathan Pace, Janne Vendt, and Cathal Walsh.…”

Pain management with epidural catheter and epidural analgesia after spinal dorsal instrumentation of lumbar spine

“…[15] While some reviews recommend epidural analgesia in spinal surgery, [36][37][38] some authors found only a modest and inconsistent clinical effect in pain reduction using epidural compared to intravenous SA techniques. [17,37] In this study, the epidural analgesic solutions revealed no significant improvement in postoperative pain control over IV analgesics alone for patients with posterior spinal fusion. We found a significant higher NRS score in the first 4 days for patients with EA than with SA, suggesting that the epidural option provided inadequate pain relief in patients after spinal surgery.…”

“…whereas other authors only found modest and inconsistent differences between the 2 procedures. [16][17][18] This study aims to compare EA and SA after SDI to clarify which method was better and more effective for pain control and pain reduction at our spine center. We also considered adverse effects and surgery-related postoperative complications.…”