目的:本研究的目的是将我们机构最近实施的强化术后恢复(ERAS)方案与先前对接受后路脊柱融合术的青少年特发性脊柱侧凸患者的术后管理进行比较,特别是评估逗留时间,阿片类药物的消费,和疼痛得分。
方法:这是一项回顾性分析,比较了住院时间,阿片类药物的消费,青少年特发性脊柱侧凸后路脊柱融合术患者的疼痛评分。在实施我们的ERAS方案之前对患者进行了分析,被认为是传统的疼痛途径(TPP),给那些接受ERAS途径的人。包括所有接受后路脊柱融合术治疗青少年特发性脊柱侧凸的患者。如果患者体重低于40公斤,则排除在外。有明显的合并症,或患有非特发性脊柱侧弯。
结果:我们检查了TPP队列中的22例患者和ERAS队列中的20例患者。与TPP相比,ERAS队列的住院时间显着减少了1.7天(P<0.01)。与TPP2.4±1.1ME/kg相比,ERAS中的阿片类药物总消费量也显着降低,为1.4±0.7吗啡当量(ME)/kg(P<0.01)。我们发现两组之间的疼痛评分没有差异。
结论:在我们的机构实施ERAS途径显著减少了青少年特发性脊柱侧凸患者后路脊柱融合术的住院时间和阿片类药物消耗。这些结果降低了与后路脊柱融合术相关的发病率和成本,并为我们的患者提供了整体改善的护理质量。
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.