Małgorzata Reysner, Grzegorz Kowalski, Alicja Geisler-Wojciechowska, Tomasz Resyner, Katarzyna Wieczorowska-Tobis
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引用次数: 0
Abstract
Study design: This was a narrative review.
Objective: The objective of this review was to summarize the current evidence and knowledge gaps regarding anesthesia and pain management for scoliosis surgery, including multimodal analgesia, and identify the best anesthetic approach to scoliosis surgery that ensures patient safety and pain relief even in the postoperative period, with minimal influence on SSEP monitoring.
Summary of background data: Spinal surgeries and fusions for scoliosis are associated with high pain levels. Inadequate analgesia can cause patient dissatisfaction, delay recovery, and increase the risk of chronic pain. Despite serious side effects, opioids are the mainstay of pain medication after scoliosis surgery. However, increasing emphasis on minimizing opioids and accelerating recovery has increased the adoption of multimodal analgesic therapy.
Materials and methods: The literature review was performed on standards of care, a pain management protocol, current therapeutic options, and innovative treatment options for patients undergoing scoliosis surgery. The literature was reviewed through 4 electronic databases: PubMed, Cochrane Library, Google Scholar, and Embase.
Results: The initial search yielded 994 articles. Forty-seven relevant articles were selected based on relevance, recentness, search quality, and citations. Ten studies described the influence of different methods of anesthesia on neuromonitoring. Twenty-one researchers studied the effect of analgesics and coanalgesics on pain relief protocol. Nine studies treated regional anesthesia and its influence on pain management.
Conclusions: The most suitable anesthetic approach that does not disturb the neuromonitoring is obtained by combining total intravenous anesthesia (TIVA) with remifentanil and propofol with regional anesthesia, particularly erector spinae plane block (ESPB), as a part of a multimodal analgesia protocol.
期刊介绍：
Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure.
Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.
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