Multimodal Analgesia and Opioid Use After Adolescent Spinal Fusion

This retrospective quality improvement initiative examined multimodal pain management for adolescents undergoing posterior spinal fusion for idiopathic scoliosis. We analyzed records of 57 patients aged 11 to 18 who received a standardized protocol including gabapentin, diazepam, acetaminophen, ibuprofen, and opioids. Despite multimodal analgesia, patients consumed an average of 23 opioid doses, exceeding the prescribed 20-dose limit. Analysis revealed statistically significant associations between higher opioid consumption and diazepam use (P < .001), with gabapentin showing nonsignificant trends (P = .145). These findings inform nurse practitioner–led discharge planning and emphasize individualized opioid stewardship strategies in pediatric postoperative care. Results highlight need for refined multimodal approaches.