For a study, researchers compared patients whose pain was controlled with patient-controlled analgesia to those whose pain was controlled with single bolus micro-dose intrathecal morphine as part of a rapid recovery pathway during posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) (PCA). Addiction to narcotic substances has increased in all patient categories, including pediatrics. Historically, narcotics have been utilized to measure pain control in complex spine procedures, primarily as PCA and supplementary take-home medicine. Researchers looked at AIS patients who had PSF between 2015 and 2019. In 2018, we instituted a standardized rapid recovery pathway for scoliosis patients undergoing PSF utilizing micro-dose intrathecal morphine (ITM-RRP). Previously, postoperative care was done using a standard regimen with PCA. The researchers examined perioperative data, morphine intake, and prescription refill requests. The overall number of AIS patients in the trial was 373, including 250 in the PCA group and 123 in the ITM-RRP group. Cobb angles (P=0.195), levels fused (P=0.481), and body mass index (P=0.075) were all similar before surgery. Around 69.14% of ITM-RRP patients spent an average of less or equal to 3 days in the hospital, compared with more than 11.6% of PCA patients (P<0.001). ITM-RRP patients ambulated considerably earlier than PCA patients, with 84.6% of ITM-RRP patients out of bed by postoperative day 1 (P<0.001) versus 8% of PCA patients. In addition, with activity and earlier beginning bowel movements, ITM-RRP patients had significantly lower VAS pain values (P<0.001). Emesis after surgery was similar (P=0.11). There were no cases of pruritus, respiratory depression, or the need for supplementary oxygen. For a study, researchers did the first outline to show that in the AIS population following PSF, a rapid recovery procedure employing single micro-dose ITM with oral analgesics provides adequate recovery, significantly better postoperative pain control, and superior perioperative outcomes than typical PCA methods.
