Document Detail

Thoracic epidural-general analgesia in scoliosis surgery.
MedLine Citation:
PMID:  20868960     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: To evaluate the efficacy of thoracic epidural analgesia (TEA) in scoliosis surgery.
DESIGN: Descriptive clinical study.
SETTING: University hospital.
PATIENTS: 15 ASA physical status I, II, and III patients undergoing thoracolumbar scoliosis correction.
INTERVENTIONS: TEA was performed at three to 5 cm cephalad to the incision, and 5 to 10 mL of 0.125% - 0.2% levobupivacaine was given initially. Then, 5 to 10 mL of levobupivacaine was infused hourly throughout the operation. General anesthesia (GA) was induced with thiopental sodium (5 mg/kg) and fentanyl (one μg/kg) and was maintained with 0.2% sevoflurane and 50% nitrous oxide in oxygen. Intraoperative epidural morphine (two to three mg) was administered, and 0.1% levobupivacaine with morphine (0.04 to 0.08 mg/mL) was infused at two to 4 mL/hr for postoperative analgesia.
MEASUREMENTS: Adequacy of anesthesia, postanesthetic recovery and analgesia, adverse effects, and patient satisfaction were recorded.
MAIN RESULTS: 20% of patients underwent more than 10 levels of correction, and 53% had coexisting morbid diseases. All had adequate anesthesia. Immediately in the Postanesthesia Care Unit (PACU), 67% of patients reached an Aldrete score of 10, and 40% were fully awake and oriented. All patients were arousable to command and able to flex their hips and knees. None had intraoperative recall. 73% reported no pain in the PACU or 6 hours postoperatively. No serious adverse effects occurred. 80% of patients rated their satisfaction as "good".
CONCLUSIONS: Preincisional application of TEA with light GA may be used effectively in thoracolumbar scoliosis surgery.
Petchara Sundarathiti; Koravee Pasutharnchat; Pornpimon Jommaroeng
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  22     ISSN:  1873-4529     ISO Abbreviation:  J Clin Anesth     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-27     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  410-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
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MeSH Terms
Analgesia, Epidural / adverse effects,  methods*
Analgesics, Opioid / administration & dosage,  adverse effects
Anesthesia Recovery Period
Anesthesia, General / adverse effects,  methods*
Anesthetics, Local / administration & dosage*,  adverse effects
Bupivacaine / administration & dosage,  adverse effects,  analogs & derivatives
Hospitals, University
Middle Aged
Morphine / administration & dosage,  adverse effects
Pain, Postoperative / drug therapy
Patient Satisfaction
Scoliosis / surgery*
Thoracic Vertebrae
Reg. No./Substance:
0/Analgesics, Opioid; 0/Anesthetics, Local; 0/levobupivacaine; 2180-92-9/Bupivacaine; 57-27-2/Morphine

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