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Comparative effectiveness of intrathecal morphine versus erector spinae plane block for analgesia after scoliosis surgery: a retrospective analysis
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DOI：10.1016/j.bas.2026.105957.png)
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Abstract
En 中文
Objective: To compare the efficacy of analgesia techniques after idiopathic scoliosis surgery. Methods: Register data of scoliosis patients were analyzed between January 2020 and June 2023. Patients were divided into four groups: intravenous anesthesia (IA) only, Erector Spinae Plane Block (ESPB), Intra-Thecal Morphine (ITM) and association of ESPB + ITM. The primary outcome measure was morphine consumption median [interquartile range] at 24 h postoperatively. We also investigated morphine consumption at 48 and 72 h, pain scores, co-analgesic drugs, and specific complications: respiratory, cardiovascular, post-lumbar puncture syndrome. Results: Among 119 patients, 52 (43.7%) received IA, 32 ESPB (26.9%), 9 ITM (7.6%) and 26 (21.8%) ITM + ESPB. Morphine consumption at 24 h was significantly (p < 0.001) reduced for patients with ITM: IA 51 mg (38-71), ESPB 46 mg (30-70), ITM 12 mg (7-29), ITM + ESPB 20 mg (10-28). This superior effect of ITM was sustained until 72 h for morphine consumption and pain scores. Compared to other techniques, the visual analog scale for pain assessment revealed a significant (p < 0.001) reduction by more than 2 points when using ITM within the first 24 postoperative hours, and lower median sufentanil doses were required during anesthesia. No postoperative complications occurred. Conclusion: In this retrospective cohort, ITM was associated with significantly reduced opioid use and improved pain scores. ESPB did not show a significant additive effect. These findings should be interpreted with caution due to the retrospective design and potential selection bias. Prospective randomized trials are needed to confirm these results. Level of evidence: 3 - Retrospective study.
Keywords:
Idiopathic scoliosis
Perioperative analgesia
Intrathecal morphine
Erector spinae plane block
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B
IF:
2.5
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220
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