Our Summary

This research paper discusses the impact of a certain kind of pain relief method (ultrasound-guided erector spinae block or USG-ESPB) on two types of monitoring techniques (SSEP and TcMEP) used during scoliosis surgery (surgery to fix a curved spine). The timing of these monitoring techniques is important, as the results are used as a reference for any changes observed during the surgery.

In two case studies, the use of this pain relief method led to a temporary but significant decrease in the effectiveness of one of the monitoring techniques (TcMEP), starting 3 minutes after the pain relief was administered and lasting for 20 minutes. The other monitoring method (SSEP) was not affected.

These findings suggest that the use of USG-ESPB may affect the accuracy of TcMEP, making it necessary for surgeons to carefully consider when they record the baseline TcMEP during a scoliosis surgery.

FAQs

  1. What impact does the ultrasound-guided erector spinae block (USG-ESPB) have on the monitoring techniques used during scoliosis surgery?
  2. How long does the decrease in effectiveness of the TcMEP monitoring technique last after the administration of USG-ESPB?
  3. Does the use of USG-ESPB affect the SSEP monitoring technique during scoliosis surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scoliosis surgery is to discuss with their surgeon the potential impact of pain relief methods on monitoring techniques during the procedure. It’s important for patients to be aware of any potential effects on monitoring accuracy and to communicate any concerns or questions with their medical team before the surgery.

Suitable For

Overall, patients who are recommended scoliosis surgery typically have a curvature of the spine that is severe enough to cause pain, discomfort, and potential complications such as difficulty breathing or reduced mobility. Surgical intervention is usually recommended when conservative treatments such as bracing, physical therapy, or observation have not been effective in managing the symptoms or preventing further progression of the curvature.

Patients who may be recommended for scoliosis surgery include:

  1. Adolescents with moderate to severe scoliosis (curvature greater than 40-50 degrees) who are still growing and have a high risk of progression.
  2. Adults with severe scoliosis that is causing pain, difficulty breathing, or other functional limitations.
  3. Patients with congenital scoliosis, neuromuscular scoliosis, or other types of scoliosis that are progressive and affecting overall health and quality of life.

It is important for patients to undergo a thorough evaluation by a spine specialist to determine if they are candidates for scoliosis surgery and to discuss the potential risks and benefits of the procedure. Additionally, patients should be informed about the potential impact of pain relief methods such as USG-ESPB on monitoring techniques during surgery, as this may affect the surgical approach and decision-making process.

Timeline

Before scoliosis surgery:

  • Patient undergoes pre-operative evaluation, including physical examination, imaging tests, and discussions with the surgical team
  • Anesthesia team discusses the anesthesia plan with the patient
  • Monitoring techniques such as SSEP and TcMEP are set up and baseline measurements are recorded
  • Patient receives pain relief methods such as USG-ESPB before surgery

During scoliosis surgery:

  • Surgeon performs the surgery to correct the curvature of the spine
  • Monitoring techniques such as SSEP and TcMEP are used to monitor spinal cord function and prevent damage during the surgery
  • Any changes in the monitoring results are noted and adjustments are made as needed

After scoliosis surgery:

  • Patient is monitored in the recovery room for any complications or side effects
  • Pain management plan is implemented to help with post-operative pain
  • Patient is discharged from the hospital with instructions for post-operative care and follow-up appointments with the surgical team

What to Ask Your Doctor

Some questions a patient should ask their doctor about scoliosis surgery include:

  1. Will monitoring techniques such as SSEP and TcMEP be used during my surgery?
  2. How will the timing of these monitoring techniques be affected if I receive ultrasound-guided erector spinae block (USG-ESPB) for pain relief?
  3. What are the potential risks or limitations of using USG-ESPB in relation to monitoring techniques during scoliosis surgery?
  4. How will the effectiveness of monitoring techniques be ensured if USG-ESPB is utilized?
  5. Are there alternative pain relief options that may not impact monitoring techniques during surgery?
  6. How will any potential changes in monitoring techniques be communicated to me during the surgery?
  7. What steps will be taken to address any temporary decrease in monitoring technique effectiveness, if it occurs?
  8. How will the use of USG-ESPB impact the overall success and outcomes of the scoliosis surgery?
  9. Can you provide more information or studies on the potential impact of USG-ESPB on monitoring techniques during scoliosis surgery?
  10. Are there any additional precautions or considerations I should be aware of if USG-ESPB is used during my surgery?

Reference

Authors: Manohara N, Pinto V, Lobo C, Byrappa V, Lobo FA. Journal: J Clin Monit Comput. 2024 Feb;38(1):229-234. doi: 10.1007/s10877-023-01058-6. Epub 2023 Jul 17. PMID: 37460867