The role of postoperative furosemide therapy in the treatment of pleural effusion following kyphosis/scoliosis surgery.

PURPOSE

Retrospective analysis of data to determine if the use of postoperative furosemide therapy decreases the incidence of thoracocentesis in children and adolescents undergoing kyphosis or scoliosis surgery. One of the potential complications seen in patients undergoing scoliosis or kyphosis surgery is the development of a clinically symptomatic postoperative pleural effusion requiring thoracocentesis, which is an invasive procedure that is associated with discomfort to the patient and a minimal risk of an iatrogenic pneumothorax.

METHODS

We retrospectively reviewed the medical records and X-rays of 190 patients who had undergone corrective surgery for AIS/kyphosis. All patients underwent an ASF or an APSF or a PSF with a minimum 3 level costoplasty. We compared the rate of thoracocentesis in group 1 (no furosemide; 161 patients) to that in group 2 (furosemide; 29 patients). Follow-up chest radiographs were evaluated for a decrease or resolution of the effusion.

RESULTS

In group 1, 26 out of the 161 patients required thoracocentesis (16%); in group 2, only 1 out of the 29 patients underwent thoracocentesis (3.4%).

CONCLUSIONS

Postoperative furosemide in patients who undergo significant pleural manipulation during spinal deformity surgery may decrease the incidence of clinically symptomatic pleural effusion requiring thoracocentesis. This study represents a true trend; however, a high level of significance can only be achieved by performing a larger randomized controlled study.