Characterizing Anesthetic Management and Perioperative Outcomes Associated with a Novel, Fusionless Scoliosis Surgery in Adolescents.

This study aims to characterize the anesthetic management and perioperative outcomes of AVT and traditional posterior spinal fusion (PSF) after establishing the technique at our institution. Scoliosis correction procedures performed in patients aged 10 to 21 years between January 2014 and August 2017 were identified in the electronic medical record. Patient characteristics and perioperative data about anesthetic use and pain management were extracted. Descriptive statistics were generated. Thirty-five patients undergoing AVT and 40 patients undergoing PSF met inclusion criteria. Preoperative fluoroscopy-guided epidural placement was used only in the AVT group (86%). The worst pain score on postoperative day (POD) 1 after AVT was a mean (SD) of 5.6 (2.3), with average pain scores on subsequent days ranging from 2.9 (1.2) to 3.6 (1.7). Total in-hospital opioid consumption in morphine milligram equivalents was 70 (76.6) for AVT and 193.4 (137.2) for PSF (P
Source: AANA Journal - Category: Anesthesiology Authors: Tags: AANA J Source Type: research

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Alcyone Lifesciences recently obtained Breakthrough Device Designation from the FDA for their novel implantable intrathecal bolus drug delivery catheter and port system, the ThecaFlex DRx System. The system is intended for use in conditions that requ...
Source: Medgadget - Category: Medical Devices Authors: Tags: Neurology Neurosurgery Pain Management Radiology Source Type: blogs
A 15-year-old boy with X-linked myotubular myopathy associated with severe hypotonia and pectus excavatum presented for posterior spinal fusion of T2-sacrum because of rest pain and severe progressive neuromuscular scoliosis. Previously, he experienced 2 separate instances of cardiac arrest after prone positioning under general anesthesia. A preoperative computed topography angiogram in the supine and prone positions revealed inferior vena cava and right ventricular outflow tract obstruction on prone positioning. Successful positioning and posterior spinal fusion occurred by staging the procedure, correction of volume stat...
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports Source Type: research
CONCLUSION: In this retrospective analysis, the use of perioperative gabapentin is associated with a statistically significant decrease in time to completing physical therapy goals after spinal fusion for adolescent idiopathic scoliosis. PMID: 29878543 [PubMed - in process]
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
Performing epidural and spinal anesthesia requires a good deal of training and being able to sense when the needle reaches the desired location. This is certainly not foolproof and some patients are harder to work with than others. One issue is that ...
Source: Medgadget - Category: Medical Devices Authors: Tags: Anesthesiology Neurology Pain Management Source Type: blogs
Publication date: Available online 12 March 2018 Source:Anaesthesia & Intensive Care Medicine Author(s): Roger Ho, Michael G. Irwin Major spinal surgery is performed for a wide variety of conditions including degenerative diseases, scoliosis and autoimmune diseases. Anaesthesia often presents several challenges to the anaesthetist. Careful pre-anaesthetic assessment and planning is important as patients may have multiple comorbidities. Important perioperative issues to consider include aspects of airway management, neurophysiological monitoring, patient positioning, blood conservation strategies, pain management and s...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
Conclusion. With an adequate postoperation pain regimen, significant pain should subside to a tolerable level by postoperative day 4 and negligible by postoperative day 7. Patient usually can be discharged on postoperative day 4 when the usage of PCA morphine was not required. Level of Evidence: 2
Source: Spine - Category: Orthopaedics Tags: Deformity Source Type: research
CONCLUSIONS A successful model (87% accuracy, 0.89 AUROC curve) was built predicting major intraoperative or perioperative complications following ASD surgery. This model can provide the foundation toward improved education and point-of-care decision making for patients undergoing ASD surgery. PMID: 28338449 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
CONCLUSION: This study highlights possible discrepancies in postoperative pain management specific to girls with Rett syndrome and suggests further investigation is warranted to determine best practice for postoperative analgesic management for this vulnerable patient population. PMID: 28177174 [PubMed - as supplied by publisher]
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
ConclusionThis study highlights possible discrepancies in postoperative pain management specific to girls with Rett syndrome and suggests further investigation is warranted to determine best practice for postoperative analgesic management for this vulnerable patient population.
Source: Pediatric Anesthesia - Category: Anesthesiology Authors: Tags: Research Report Source Type: research
We describe the anesthetic management of a parturient with VACTERL association, who underwent neuraxial analgesia for labor and vaginal delivery. CASE REPORT: A 23 year old primigravida at 39 weeks gestation presented in labor at 4cm cervical dilatation, completely effaced, requesting labor analgesia. Past medical history included VACTERL association with an imperforate anus and a partial endocardial cushion defect, both repaired in early childhood. She also had significant dorso-lumbar scoliosis with an extra lumbar vertebra. An MRI performed at 14 years age revealed the above findings with no spinal cord abnormalitie...
Source: Revista Brasileira de Anestesiologia - Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research
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