THE SAFETY OF CONTINUOUS EPIDURAL INFUSION FOR POSTOPERATIVE ANALGESIA IN PEDIATRIC SPINE SURGERY

Epidural analgesia and anesthesia are standard regional techniques in orthopaedic surgery of the lower extremities. Benefits of epidural ane sthetic infusions include excellent analgesia, minimal respiratory dep ression, no somnolence, and decreased need for blood transfusion. Adve rse effects include pruritus, nausea, and urinary retention, but stand ard methods have evolved to counter each adverse effect. A continuous epidural infusion of opioid and bupivacaine was used as the principal postoperative analgesic for 71 young patients undergoing surgery for t he correction of spinal deformity. The infusion was titrated to a poin t at which each patient denied having any pain and was maintained for an average of 2.9 days. Sixty-four patients experienced satisfactory a nalgesia with minimal adverse effects. The technique worked despite mu ltiple laminotomies for segmental fixation and did not compromise neur ologic assessment. We conclude that epidural analgesia is as safe and effective after spinal-deformity surgery as it is after other types of surgery.