Danielewicz Anna, Fatyga Marek, Starobrat Grzegorz, Różańska-Boczula Monika, Wójciak Magdalena, Sowa Ireneusz, Dresler Sławomir, Latalski Michał
Department of Paediatric Orthopaedics, Medical University of Lublin, 20-093 Lublin, Poland.
Childrens' Ortopeadic Department, Childrens' University Hospital in Lublin, 20-093 Lublin, Poland.
J Clin Med. 2021 May 29;10(11):2407. doi: 10.3390/jcm10112407.
Spinal deformity corrections in paediatric patients are long-lasting procedures involving damage to many tissues and long pain exposure; therefore, effective pain management after surgical treatment is an important issue. In this study, the effect of inclusion of local infiltration analgesia, as an integral part of the scheme in postoperative pain control, in children and adolescents, subjected to the spinal deformity correction procedure, was assessed. Thirty patients, aged 8 to 17 years, undergoing spinal deformity correction were divided into a study group, receiving a 0.25% bupivacaine solution before wound closure, and a control group (no local analgesic agent). Morphine, at the doses of 0.10 mg/kg of body weight, was administered to the patients when pain occurred. Pain scores, morphine administration, and bleeding were observed during 48 postoperative hours. The pain scores were slightly lower in a 0-4 h period in patients who received bupivacaine compared with those in the control group. However, no differences were observed in a longer period of time and in the total opioid consumption. Moreover, increasing bleeding was observed in the bupivacaine-treated patients (study group) vs. the control. Bupivacaine only modestly affects analgesia and, due to the increased bleeding observed, it should not to be part of pain control management in young patients after spinal deformity correction.
小儿患者的脊柱畸形矫正手术是一种持久的手术，涉及许多组织的损伤和长时间的疼痛暴露；因此，术后有效的疼痛管理是一个重要问题。在本研究中，评估了将局部浸润镇痛作为脊柱畸形矫正手术患儿和青少年术后疼痛控制方案的一个组成部分的效果。30例年龄在8至17岁接受脊柱畸形矫正手术的患者被分为研究组和对照组，研究组在伤口闭合前接受0.25%布比卡因溶液，对照组不使用局部镇痛剂。疼痛发生时，给患者按0.10 mg/kg体重的剂量注射吗啡。在术后48小时内观察疼痛评分、吗啡使用情况和出血量。与对照组相比，接受布比卡因的患者在术后0至4小时的疼痛评分略低。然而，在更长时间内以及总阿片类药物消耗量方面未观察到差异。此外，与对照组相比，接受布比卡因治疗的患者（研究组）出血量增加。布比卡因仅适度影响镇痛效果，且由于观察到出血增加，它不应成为小儿脊柱畸形矫正术后疼痛控制管理的一部分。
