Our Summary

This research paper discusses a new way to manage post-surgery pain in children who have undergone surgery for congenital or neurogenic scoliosis, a condition that causes curvature of the spine. After such surgery, patients usually experience intense pain and often need powerful painkillers, known as opioids, for a long period. However, these drugs can have serious side effects.

In this study, the researchers used a different approach called ’erector spinae plane blocks’ (ESPB), in combination with a steroid medication, general anesthesia, and controlled ventilation. This technique was applied to six children before they underwent spinal fusion surgery.

The results showed that all the children had very low levels of pain after their operations. Furthermore, they needed fewer opioids, which also means they were less likely to experience side effects from these drugs.

In conclusion, the researchers suggest that using ESPB in patients who are having scoliosis surgery could be an effective way to manage pain and reduce the need for opioids.

FAQs

  1. What is the new method proposed by the researchers to manage post-surgery pain in pediatric scoliosis patients?
  2. What were the results of using the ’erector spinae plane blocks’ technique in children who underwent scoliosis surgery?
  3. How does the use of ’erector spinae plane blocks’ in scoliosis surgery help to reduce the need for opioids?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pediatric scoliosis surgery is to discuss the possibility of using erector spinae plane blocks (ESPB) as a pain management technique. This approach has shown promising results in reducing post-surgery pain and the need for opioids, which can have negative side effects. By incorporating ESPB into the treatment plan, patients may experience improved pain control and a faster recovery process. It is important to have an open conversation with your healthcare provider about all available pain management options before undergoing scoliosis surgery.

Suitable For

Patients who are typically recommended for pediatric scoliosis surgery are those who have severe curvature of the spine that is causing pain, difficulty breathing, or affecting their quality of life. This may include patients with congenital scoliosis, neuromuscular scoliosis, or idiopathic scoliosis that has not responded to other treatments such as bracing or physical therapy. Additionally, patients who have progressive curves that are likely to worsen over time may also be recommended for surgery. It is important for patients and their families to discuss the risks and benefits of surgery with their healthcare provider to determine the best course of treatment for their individual situation.

Timeline

Timeline of a patient’s experience before and after pediatric scoliosis surgery:

Before surgery:

  • Patient is diagnosed with scoliosis and undergoes pre-operative evaluations and tests.
  • Patient and their family meet with the surgical team to discuss the procedure, risks, and expected outcomes.
  • Patient may undergo physical therapy or bracing to try to correct the curvature of the spine before surgery.
  • Patient may be prescribed medications to manage pain and inflammation leading up to the surgery.

During surgery:

  • Patient undergoes spinal fusion surgery to correct the curvature of their spine.
  • Erector spinae plane block (ESPB) is administered to manage post-operative pain.
  • Patient receives general anesthesia and controlled ventilation during the procedure.

After surgery:

  • Patient wakes up in the recovery room and is closely monitored for any complications.
  • Patient may experience some pain and discomfort, but the ESPB helps manage this effectively.
  • Patient is gradually weaned off of opioids and other pain medications as pain levels decrease.
  • Patient begins physical therapy and rehabilitation to regain strength and mobility in their spine.
  • Patient follows up with their surgical team for post-operative appointments and monitoring of their recovery progress.

Overall, the use of ESPB in pediatric scoliosis surgery can help to improve pain management, reduce the need for opioids, and promote a faster and smoother recovery for the patient.

What to Ask Your Doctor

  1. What is pediatric scoliosis surgery and why is it necessary for my child?
  2. What are the potential risks and complications associated with pediatric scoliosis surgery?
  3. How long is the recovery process after pediatric scoliosis surgery?
  4. What pain management options are available for my child after surgery?
  5. Can alternative pain management techniques, such as erector spinae plane blocks, be used for my child’s surgery?
  6. What are the potential side effects of using opioids for pain management in children?
  7. How will the use of erector spinae plane blocks affect my child’s recovery and long-term outcomes?
  8. Are there any specific precautions or recommendations for managing pain in children with congenital or neurogenic scoliosis?
  9. How will the pain management plan be personalized for my child’s individual needs and condition?
  10. Are there any other alternative pain management techniques that could be beneficial for my child’s surgery?

Reference

Authors: Domagalska M, Ciftci B, Kolasinski J, Kowalski G, Wieczorowska-Tobis K. Journal: Medicina (Kaunas). 2023 Aug 7;59(8):1429. doi: 10.3390/medicina59081429. PMID: 37629719