Jinnah Alexander H, McCallie Rosser, Marquez-Lara Alejandro, Tully Nicholas, Hughes Michael S, Frino John
Wake Forest School of Medicine, Department of Orthopaedic Surgery, Winston Salem, North Carolina.
J Surg Orthop Adv. 2024 Winter;33(4):219-221.
Postoperative pain control in adolescent patients following posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) requires a multimodal pain regimen involving a combination of opioids and adjuvant analgesic medications. The purpose of this study was to identify whether the use of the local anesthetic liposomal bupivacaine (LB) at time of closure following PSF reduced postoperative narcotic use in patients when compared with an alternative local anesthetic. Twenty-five patients who received LB at time of wound closure were matched with 25 AIS patients from the year prior to minimize changes in protocol and instrumentation. Charts were retrospectively reviewed, and significant difference was found in age, gender, body mass index, length of stay, visual analog scores for pain, or number of levels fused. However, the LB group had significantly less morphine equivalent totals. Based on the results, the authors would recommend the use of LB during closure of PSF for AIS. (Journal of Surgical Orthopaedic Advances 33(4):219-221, 2024).
对于青少年特发性脊柱侧凸（AIS）患者，在进行后路脊柱融合术（PSF）后，术后疼痛控制需要采用多模式镇痛方案，包括联合使用阿片类药物和辅助镇痛药物。本研究的目的是确定在PSF术后关闭切口时使用局部麻醉药脂质体布比卡因（LB）与使用另一种局部麻醉药相比，是否能减少患者术后的麻醉药物使用量。25例在伤口关闭时接受LB治疗的患者与前一年的25例AIS患者进行匹配，以尽量减少方案和器械方面的变化。对病历进行回顾性审查，发现两组在年龄、性别、体重指数、住院时间、疼痛视觉模拟评分或融合节段数量方面没有显著差异。然而，LB组的吗啡等效总量显著较少。基于这些结果，作者建议在AIS患者的PSF手术关闭切口时使用LB。（《外科骨科进展杂志》33(4):219 - 221, 2024）
