Effects of opioid-reduced anesthesia during scoliosis surgery in children: a prospective observational study

Pain Manag. 2021 Nov;11(6):679-687. doi: 10.2217/pmt-2020-0100. Epub 2021 Jun 9.

Abstract

Aims: Opioid-reduced anesthesia (ORA) was suggested to decrease morphine consumption after adolescent idiopathic scoliosis (AIS) surgery and incidence of chronic pain. Materials & methods: A prospective analysis using the ORA in AIS surgery was performed. Two cohorts were compared: a control group (opioid-based anesthesia) and the ORA group. The main outcome was morphine consumption at day 1. Results: 33 patients operated for AIS using ORA were compared with 36 with opioid-based anesthesia. Morphine consumption was decreased in the ORA group (1.1 mg.kg-1 [0.2-2] vs 0.8 mg.kg-1 [0.3-2]; p = 0.02) at day 1. Persistent neuropathic pain at 1 year was decreased in the ORA group (p = 0.02). Conclusion: The ORA protocol is efficient to reduce postoperative morphine consumption in AIS surgery and preventing neuropathic pain.

Keywords: adolescent idiopathic scoliosis; fast track rehabilitation; opioid-free anesthesia; persistent neuropathic pain; posterior fusion.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Analgesics, Opioid / therapeutic use
  • Anesthesia*
  • Child
  • Humans
  • Morphine / therapeutic use
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / prevention & control
  • Retrospective Studies
  • Scoliosis* / surgery
  • Spinal Fusion*

Substances

  • Analgesics, Opioid
  • Morphine