Abstract
EFFECTS OF INTRAOPERATIVE EPIDURAL ADMINISTRATION OF ROPIVACAINE ON POSTOERATIVE ANALGESIA IN SCOLIOSIS SURGERY: A RETROSPECTIVE STUDY

*Tomoki Nishiyama MD, PhD

ABSTRACT

Background: Scoliosis surgery induced severe postoperative pain. We investigated postoperative analgesic effects of intraoperative epidural administration of ropivacaine in spinal fusion surgery for scoliosis. Methods: Patient records of 20 patients aged 20 to 40 years, who received scoliosis surgery (posterior spinal fusion of 6 to 15 vertebrae), 10 of these received intraoperative epidural administration of ropivacaine (epidural group) and 10 did not receive epidural ropivacaine (control group) in the same period, were extracted to match their background. Anesthesia was induced with midazolam, propofol, fentanyl and vecuronium, and maintained with infusion of propofol and remifentanil. After surgery subdermal infusion of fentanyl 25 μg/h was administered. In the epidural group only, a direct epidural administration of 0.375% ropivacaine about 1.5 mL/vertebra was done by surgeon when epidural space was visible during surgery. Anesthetics, hemodynamics, pain shown by visual analog scale (VAS; 0-10), and consumption of rescue analgesics were extracted from patients’ records, and compared between the two groups. Results: Consumption of remifentanil, nicardipine, and pentazocine were significantly smaller in the epidural group. Blood pressure at the end of anesthesia, heart rate at 2, 6, 12, and 24 hours after surgery, and pain shown by visual analog scale (VAS) at 1, 2, 6, and 12 hours after surgery were significantly smaller in the epidural group. Conclusions: An epidural administration of 0.375% ropivacaine during surgery was effective for postoperative analgesia at least for 12 hours after scoliosis surgery.

Keywords: Scoliosis, postoperative analgesia, epidural block, ropivacaine.


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