Effectiveness and Safety of Continuous Infusion Regional Anesthesia Pumps for Pain after Thoracopelvic Fusion Surgeries for Persistent Spinal Pain Syndrome.

Abstract

INTRODUCTION\nPostoperative pain after complex revision spine surgeries, especially for the treatment of persistent spinal pain syndrome (PSPS), is frequently severe and can be debilitating, requiring the use of intravenous and oral opioids. This is the first study aimed at evaluating the effectiveness and safety of continuous infusion regional anesthesia pumps placed after thoracopelvic fusions for the treatment of PSPS.\n\n\nMETHODS\nThis is a retrospective comparative study of consecutive patients who underwent thoracopelvic fusion for PSPS. The patients included in this study either had a continuous infusion regional anesthesia pump placed during surgery or not (control). Demographics, use of preoperative and postoperative opioids, postoperative adverse events, length of hospital stay, and 90-days readmission were recorded.\n\n\nRESULTS\nPatients in the pump group (n=14) used less opioids during their hospital stay than the control group (n=12) (p=0.6). This difference was greater during the first 2 days (p=0.3 and p=0.2, respectively). There was no significant difference in opioid utilization during the first 14 days after surgery (p=0.8) and at the 3-month postoperative follow-up evaluation (p=0.8). Furthermore, there was no significant difference between groups in terms of postoperative complications. The pump group had a 1.4-day shorter hospital stay (p=0.7). The control group had more 90-day readmissions than the pump group (p=0.2).\n\n\nCONCLUSION\nDespite showing a trend towards less utilization of opioids during the first 2 days after surgery and a shorter hospital stay with no increased complications in the pump group, the study data failed to demonstrate a statistically significant difference between groups.