Multi-Institutional Study of Multimodal Analgesia Practice, Pain Trajectories, and Recovery Trends After Spine Fusion for Idiopathic Scoliosis
Authors' conclusion
MMA strategies showed site-specific variability and decreasing yearly trends of in-hospital opioid use without changes in acute or chronic pain after PSF.
Study context
- Population
- Subjects 8–25 years undergoing posterior spinal fusion (PSF) for idiopathic scoliosis, 6 US sites, 2016–2023
- Participants
- 343 subjects · 6 sites
- Exposure
- Chronic postsurgical pain (CPSP) vs non-CPSP
- CPSPn = 64
- Outcome
- Perioperative MMA use, pain trajectories and recovery over 12 months
- Follow-up
- 12 months
Methodological details6 US sites, descriptive analyses, group-based trajectory modelling
- 6 US sites
- Descriptive analyses
- Group-based trajectory modelling
Main finding
As reported in the abstract
- Perioperative use of opioids and nonopioid analgesics varied significantly across sites
- P < .001
- Preoperative gabapentinoids
- 48.2% (157/343)
- Intraoperative remifentanil infusion
- 264/337 [78.3%]
- Intraoperative fentanyl infusion
- 73/337 [21.7%]
- Intraoperative methadone boluses
- 159/338 [47%]
- Postoperative PCA
- 342/343 [99.9%]
- Yearly change in median in-hospital opioid use (morphine milligram equivalents (MME)/kg/postoperative days (POD) 0 to 1 per year), SE 0.02
- −0.08
- Time in moderate-to-severe pain on POD 0 to 1
- ≈33%
- CPSP
- 24.2% (64/264)
- Ongoing neuropathic/likely neuropathic pain
- ≈17%
- Resolving pain trajectories (2 of 4)
- 71%
- Persistent mild and moderate-to-severe pain trajectories (2 of 4)
- 29%
Observational data: associations, not effects.
Further findings
Yearly trends in nonopioid in-hospital analgesia
- Increased ketamine use
- P < 0.001
- Increased methadone use
- P < 0.001
- Increased dexmedetomidine use
- P < 0.001
- Increased RA use
- P = 0.015
FDI and PedsQL, CPSP vs non-CPSP · each time point
- FDI and PedsQL improved over time in both groups
- P < 0.001
- FDI higher in CPSP vs non-CPSP
- P < 0.001
- PedsQL lower in CPSP vs non-CPSP
- P = 0.001
Original publication
Multi-Institutional Study of Multimodal Analgesia Practice, Pain Trajectories, and Recovery Trends After Spine Fusion for Idiopathic Scoliosis. Anesth Analg. Published 2 January 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →