Spisak Kristen, Thomas Matthew D, Sirois Zachary J, Jones Alvin, Brown Lucinda, Froehle Andrew W, Albert Michael
Anesthesia, Dayton Children's Hospital, Dayton, USA.
Orthopedic Surgery, Dayton Children's Hospital, Dayton, USA.
Cureus. 2023 Aug 7;15(8):e43079. doi: 10.7759/cureus.43079. eCollection 2023 Aug.
The goal of this study was to compare our institution's recently implemented enhanced recovery after surgery (ERAS) protocol to previous post-operative management for adolescent idiopathic scoliosis patients undergoing posterior spinal fusion, specifically assessing length of stay, opioid consumption, and pain scores.
This is a retrospective analysis that compares the length of stay, opioid consumption, and pain scores of patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis. Patients were analyzed prior to the implementation of our ERAS protocol, deemed the traditional pain pathway (TPP), to those who underwent the ERAS pathway. All patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis were included. Patients were excluded if they weighed less than 40kg, had significant comorbidities, or had non-idiopathic causes of scoliosis.
We examined 22 patients in the TPP cohort and 20 in the ERAS cohort. Length of stay in the ERAS cohort was significantly reduced compared to the TPP by 1.7 days (P<0.01). Overall opioid consumption was also significantly reduced in the ERAS with 1.4 ± 0.7 morphine equivalents (ME)/kg compared to the TPP 2.4 ± 1.1 ME/kg (P < 0.01). We found no difference in pain scores between the two groups.
Implementation of an ERAS pathway at our institution significantly reduced length of stay and opioid consumption in adolescent idiopathic scoliosis patients undergoing posterior spinal fusion. These outcomes reduce morbidity and costs associated with posterior spinal fusion and provide an overall improvement in the quality of care for our patients.
本研究的目的是将我们机构最近实施的术后加速康复（ERAS）方案与青少年特发性脊柱侧凸患者后路脊柱融合术后的既往管理方法进行比较，特别评估住院时间、阿片类药物消耗量和疼痛评分。
这是一项回顾性分析，比较青少年特发性脊柱侧凸患者后路脊柱融合术后的住院时间、阿片类药物消耗量和疼痛评分。对在我们的ERAS方案实施之前（即传统疼痛路径，TPP）和接受ERAS路径的患者进行分析。纳入所有接受青少年特发性脊柱侧凸后路脊柱融合术的患者。如果患者体重小于40kg、有严重合并症或有非特发性脊柱侧凸病因，则将其排除。
我们检查了TPP队列中的22名患者和ERAS队列中的20名患者。与TPP相比，ERAS队列的住院时间显著缩短了1.7天（P<0.01）。ERAS组的总体阿片类药物消耗量也显著降低，为1.4±0.7吗啡当量（ME）/kg，而TPP组为2.4±1.1ME/kg（P<0.01）。我们发现两组之间的疼痛评分没有差异。
在我们机构实施ERAS路径显著缩短了青少年特发性脊柱侧凸患者后路脊柱融合术后的住院时间和阿片类药物消耗量。这些结果降低了与后路脊柱融合相关的发病率和成本，并总体改善了我们患者的护理质量。
