Regional Anesthetic Approaches for Postoperative Analgesia Following Vertebral Body Tethering: A Case Series

Abstract

Vertebral body tethering (VBT) is an innovative surgical technique used to treat juvenile and adolescent idiopathic scoliosis. The optimal anesthetic technique, including the preferred management of postoperative pain, is not known. In this case series, we describe 3 patients with adolescent idiopathic scoliosis who received either continuous erector spinae plane block (ESPB) catheters or intercostal liposomal bupivacaine for postoperative pain management after bilateral VBT via minithoracotomy. (A&A Practice. 2021;15:e01510.

Multimodal Approach to Vertebral Body Tethering With Erector Spinae Plane Blocks and Cryoablation

“…To date, there is no current literature describing the combination of the ESPB, cryoablation, and multimodal medications as part of an analgesic plan for vertebral body tethering. A case series by Lee and Kydes [9] examined continuous bilateral erector spinae plane catheters compared with intercostal nerve blocks performed with liposomal bupivacaine for vertebral body tethering, with both techniques leading to satisfactory pain relief. However, our analgesic plan is unique in that it could provide long-term analgesia by incorporating cryoablation and also included medications with pain-modulating properties such as methadone, ketamine, and gabapentin.…”