Progress in perioperative pain management of pediatric and adolescent spinal deformity corrective surgery_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Haozhong , XIU Peng , WANG Lei ,  SONG Yueming

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding author：

SONG Yueming, Email: hx_sym@163.com

Keywords：

Pediatric; adolescent; spinal deformity; perioperative; pain management; multimodal analgesia

DOI：

10.7507/1002-1892.201810122

Video：

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Objective To review the advances in perioperative pain management of pediatric and adolescent spinal deformity corrective surgery.Methods Regular analgesics, drug administrations, and analgesic regimens were reviewed and summarized by consulting domestic and overseas related literatures about perioperative pain management of pediatric and adolescent spinal deformity corrective surgery in recent years.Results As for perioperative analgesis regimens of pediatric and adolescent spinal deformity corrective surgery, regular analgesics include non-steroidal anti-inflammatory drugs, opioids, antiepileptic drugs, adrenergic agonists, and local anesthetic, etc. Besides drug administration by mouth, intravenous injection, and intramuscular injection, the administration also includes patient controlled analgesia, epidural injection, and intrathecal injection. Multimodal analgesia is the most important regimen currently.Conclusion Heretofore, a number of perioperative pain managements of pediatric and adolescent spinal deformity corrective surgery have been applied clinically, but the ideal regimen has not been developed. To design a safe and effective analgesic regimen needs further investigations.

Citation： WANG Haozhong, XIU Peng, WANG Lei, SONG Yueming. Progress in perioperative pain management of pediatric and adolescent spinal deformity corrective surgery. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(5): 644-649. doi: 10.7507/1002-1892.201810122 Copy

1.	高军胜, 张陆, 刘志昂, 等. IL-6 基因多态性与青少年特发性脊柱侧凸易感性及支具矫形疗效的相关性研究. 中国修复重建外科杂志, 2018, 32(6): 678-684.
2.	朱欢叶, 李波, 简月奎, 等. Lenke 1 型青少年特发性脊柱侧弯矫形术中不同近端固定椎的疗效分析. 中国修复重建外科杂志, 2019, 33(1): 41-48.
3.	Hamers JP, Abu-Saad HH. Children’s pain at home following (adeno) tonsillectomy. Eur J Pain, 2002, 6(3): 213-219.
4.	Perry M, Starkweather A, Baumbauer K, et al. Factors leading to persistent postsurgical pain in adolescents undergoing spinal fusion: an integrative literature review. J Pediatr Nurs, 2018, 38: 74-80.
5.	Yang S, Werner BC. Risk factors for prolonged postoperative opioid use after spinal fusion for adolescent idiopathic scoliosis. J Pediatr Orthop, 2018. [Epub ahead of print].
6.	谭岚月, 黄焜, 左云霞. 国内大型综合医院和儿童医院小儿术后镇痛调查. 国际麻醉学与复苏杂志, 2014, 35(12): 1109-1112, 1116.
7.	Hayes J, Pehora C, Bissonnette B. The use of NSAIDs in pediatric scoliosis surgery-a survey of physicians’ prescribing practice. Paediatr Anaesth, 2009, 19(8): 756-763.
8.	Jöbsis JJ, Alabbas A, Milner R, et al. Acute kidney injury following spinal instrumentation surgery in children. World J Nephrol, 2017, 6(2): 79-85.
9.	Koch HJ. Pharmacotherapy aspects during Harrington’s method of spinal surgery. Soz Praventivmed, 1995, 40(4): 230-233.
10.	王芳, 朱慧英, 张军, 等. 静脉吗啡用于小儿矫形手术术后镇痛的研究. 临床麻醉学杂志, 2002, 18(3): 165-166.
11.	Rosenberg RE, Trzcinski S, Cohen M, et al. The association between adjuvant pain medication use and outcomes following pediatric spinal fusion. Spine (Phila Pa 1976), 2017, 42(10): E602-E608.
12.	Choudhry DK, Brenn BR, Sacks K, et al. Evaluation of gabapentin and clonidine use in children following spinal fusion surgery for idiopathic scoliosis: a retrospective review. J Pediatr Orthop, 2017. [Epub ahead of print].
13.	Gornitzky AL, Flynn JM, Muhly WT, et al. A rapid recovery pathway for adolescent idiopathic scoliosis that improves pain control and reduces time to inpatient recovery after posterior spinal fusion. Spine Deform, 2016, 4(4): 288-295.
14.	Rusy LM, Hainsworth KR, Nelson TJ, et al. Gabapentin use in pediatric spinal fusion patients: a randomized, double-blind, controlled trial. Anesth Analg, 2010, 110(5): 1393-1398.
15.	Weldon BC, Connor M, White PF. Pediatric PCA: the role of concurrent opioid infusions and nurse-controlled analgesia. Clin J Pain, 1993, 9(1): 26-33.
16.	Amaranath L, Andrish JT, Gurd AR, et al. Efficacy of intermittent epidural morphine following posterior spinal fusion in children and adolescents. Clin Orthop Relat Res, 1989, (249): 223-226.
17.	Klatt JW, Mickelson J, Hung M, et al. A randomized prospective evaluation of 3 techniques of postoperative pain management after posterior spinal instrumentation and fusion. Spine (Phila Pa 1976), 2013, 38(19): 1626-1631.
18.	Tobias JD, Gaines RW, Lowry KJ, et al. A dual epidural catheter technique to provide analgesia following posterior spinal fusion for scoliosis in children and adolescents. Paediatr Anaesth, 2001, 11(2): 199-203.
19.	Erdogan MA, Ozgul U, Ucar M, et al. Patient-controlled intermittent epidural bolus versus epidural infusion for posterior spinal fusion after adolescent idiopathic scoliosis: prospective, randomized, double-blinded study. Spine (Phila Pa 1976), 2017, 42(12): 882-886.
20.	Ibach BW, Loeber C, Shukry M, et al. Duration of intrathecal morphine effect in children with idiopathic scoliosis undergoing posterior spinal fusion. J Opioid Manag, 2015, 11(4): 295-303.
21.	Tripi PA, Poe-Kochert C, Potzman J, et al. Intrathecal morphine for postoperative analgesia in patients with idiopathic scoliosis undergoing posterior spinal fusion. Spine (Phila Pa 1976), 2008, 33(20): 2248-2251.
22.	Sethna NF, Berde CB. Continuous subarachnoid analgesia in two adolescents with severe scoliosis and impaired pulmonary function. Reg Anesth, 1991, 16(6): 333-336.
23.	Hong RA, Gibbons KM, Li GY, et al. A retrospective comparison of intrathecal morphine and epidural hydromorphone for analgesia following posterior spinal fusion in adolescents with idiopathic scoliosis. Paediatr Anaesth, 2017, 27(1): 91-97.
24.	Dahl JB, Kehlet H. The value of pre-emptive analgesia in the treatment of postoperative pain. Br J Anaesth, 1993, 70(4): 434-439.
25.	Machida M, Imamura Y, Usui T, et al. Effects of preemptive analgesia using continuous subcutaneous morphine for postoperative pain in scoliosis surgery: a randomized study. J Pediatr Orthop, 2004, 24(5): 576-580.
26.	Poe-Kochert C, Tripi PA, Potzman J, et al. Continuous intravenous morphine infusion for postoperative analgesia following posterior spinal fusion for idiopathic scoliosis. Spine (Phila Pa 1976), 2010, 35(7): 754-757.
27.	谢菡, 马正良, 陈正香, 等. 病人自控静脉镇痛在脊柱侧弯患者术后镇痛中的效果评价. 药学与临床研究, 2016, 24(2): 164-166.
28.	Ravish M, Muldowney B, Becker A, et al. Pain management in patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion: combined intrathecal morphine and continuous epidural versus PCA. J Pediatr Orthop, 2012, 32(8): 799-804.
29.	张萍, 郑曼, 张媛, 等. 鞘内注射吗啡用于脊柱矫形术后镇痛. 临床麻醉学杂志, 2009, 25(12): 1062-1063.
30.	Hong R, Gauger V, Caird MS, et al. Narcotic-only epidural infusion for posterior spinal fusion patients: a single-center, retrospective review. J Pediatr Orthop, 2016, 36(5): 526-529.
31.	Hiller A, Helenius I, Nurmi E, et al. Acetaminophen improves analgesia but does not reduce opioid requirement after major spine surgery in children and adolescents. Spine (Phila Pa 1976), 2012, 37(20): E1225-E1231.
32.	Chan CYW, Loo SF, Ong JY, et al. Feasibility and outcome of an accelerated recovery protocol in asian adolescent idiopathic scoliosis patients. Spine (Phila Pa 1976), 2017, 42(24): E1415-E1422.
33.	Chidambaran V, Subramanyam R, Ding L, et al. Cost-effectiveness of intravenous acetaminophen and ketorolac in adolescents undergoing idiopathic scoliosis surgery. Paediatr Anaesth, 2018, 28(3): 237-248.
34.	Kádas I, Könczöl F, Illés T. Fatal acute liver damage caused by a therapeutic dose of paracetamol. Orv Hetil, 1998, 139(4): 189-191.
35.	Munro HM, Walton SR, Malviya S, et al. Low-dose ketorolac improves analgesia and reduces morphine requirements following posterior spinal fusion in adolescents. Can J Anaesth, 2002, 49(5): 461-466.
36.	Horn PL, Wrona S, Beebe AC, et al. A retrospective quality improvement study of ketorolac use following spinal fusion in pediatric patients. Orthop Nurs, 2010, 29(5): 342-343.
37.	Sucato DJ, Lovejoy JF, Agrawal S, et al. Postoperative ketorolac does not predispose to pseudoarthrosis following posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis. Spine (Phila Pa 1976), 2008, 33(10): 1119-1124.
38.	Vitale MG, Choe JC, Hwang MW, et al. Use of ketorolac tromethamine in children undergoing scoliosis surgery. an analysis of complications. Spine J, 2003, 3(1): 55-62.
39.	张杜枭, 于锋, 葛卫红, 等. 不同剂量氟比洛芬酯联合芬太尼在脊柱侧凸矫形术术后镇痛作用比较. 药学与临床研究, 2015, 23(2): 182-184.
40.	徐学武, 李青波, 刘骥, 等. 地佐辛与氟比洛芬酯在脊柱侧弯患者术后镇痛中作用的比较. 中华临床医师杂志 (电子版), 2013, 7(13): 6155-6156.
41.	谢菡, 马正良, 陈正香, 等. 脊柱侧弯矫形术术后使用氟比洛芬酯注射液镇痛效果的影响因素分析. 药物流行病学杂志, 2018, 27(1): 10-13.
42.	Kwan MK, Chiu CK, Chan TS, et al. Trajectory of postoperative wound pain within the first 2 weeks following posterior spinal fusion surgery in adolescent idiopathic scoliosis patients. Spine (Phila Pa 1976), 2017, 42(11): 838-843.
43.	Jones JS, Cotugno RE, Singhal NR, et al. Evaluation of dexmedetomidine and postoperative pain management in patients with adolescent idiopathic scoliosis: conclusions based on a retrospective study at a tertiary pediatric hospital. Pediatr Crit Care Med, 2014, 15(6): e247-e252.
44.	Samartzis D, Bow C, Cheung JP, et al. Efficacy of postoperative pain management using continuous local anesthetic infusion at the iliac crest bone graft site in patients with adolescent idiopathic scoliosis: a parallel, double-blinded, Randomized Controlled Pilot Trial. Global Spine J, 2016, 6(3): 220-228.
45.	Reynolds RA, Legakis JE, Tweedie J, et al. Postoperative pain management after spinal fusion surgery: an analysis of the efficacy of continuous infusion of local anesthetics. Global Spine J, 2013, 3(1): 7-14.
46.	Lowry KJ, Tobias J, Kittle D, et al. Postoperative pain control using epidural catheters after anterior spinal fusion for adolescent scoliosis. Spine (Phila Pa 1976), 2001, 26(11): 1290-1293.
47.	Adu-Gyamfi Y. Epidural morphine plus bupivacaine for relief of post-operative pain following Harrington rod insertion for correction of idiopathic scoliosis. J Int Med Res, 1995, 23(3): 211-217.
48.	Gauger VT, Voepel-Lewis TD, Burke CN, et al. Epidural analgesia compared with intravenous analgesia after pediatric posterior spinal fusion. J Pediatr Orthop, 2009, 29(6): 588-593.
49.	Aĭzenberg VL, Ul’rikh GE, Ukolov KIu, et al. Methods of analgesia in children after surgical correction of the scoliotic spinal deformities. Anesteziol Reanimatol, 2011, (1): 59-62.
50.	Cassady JF Jr, Lederhaas G, Cancel DD, et al. A randomized comparison of the effects of continuous thoracic epidural analgesia and intravenous patient-controlled analgesia after posterior spinal fusion in adolescents. Reg Anesth Pain Med, 2000, 25(3): 246-253.
51.	Taenzer AH, Clark C. Efficacy of postoperative epidural analgesia in adolescent scoliosis surgery: a meta-analysis. Paediatr Anaesth, 2010, 20(2): 135-143.
52.	Buck ML, Willson DF. Use of dexmedetomidine in the pediatric intensive care unit. Pharmacotherapy, 2008, 28(1): 51-57.
53.	姬乐婷, 张建辉. 不同剂量右美托咪定复合舒芬太尼在小儿脊柱侧弯矫正术术后镇痛效果的比较. 北方药学, 2018, 15(7): 7-9.
54.	Aydogan MS, Korkmaz MF, Ozgül U, et al. Pain, fentanyl consumption, and delirium in adolescents after scoliosis surgery: dexmedetomidine vs midazolam. Paediatr Anaesth, 2013, 23(5): 446-452.
55.	Thomas JJ, Levek C, Quick HD, et al. Utility of gabapentin in meeting physical therapy goals following posterior spinal fusion in adolescent patients with idiopathic scoliosis. Paediatr Anaesth, 2018, 28(6): 558-563.
56.	Mayell A, Srinivasan I, Campbell F, et al. Analgesic effects of gabapentin after scoliosis surgery in children: a randomized controlled trial. Paediatr Anaesth, 2014, 24(12): 1239-1244.

1. 高军胜, 张陆, 刘志昂, 等. IL-6 基因多态性与青少年特发性脊柱侧凸易感性及支具矫形疗效的相关性研究. 中国修复重建外科杂志, 2018, 32(6): 678-684.
2. 朱欢叶, 李波, 简月奎, 等. Lenke 1 型青少年特发性脊柱侧弯矫形术中不同近端固定椎的疗效分析. 中国修复重建外科杂志, 2019, 33(1): 41-48.
3. Hamers JP, Abu-Saad HH. Children’s pain at home following (adeno) tonsillectomy. Eur J Pain, 2002, 6(3): 213-219.
4. Perry M, Starkweather A, Baumbauer K, et al. Factors leading to persistent postsurgical pain in adolescents undergoing spinal fusion: an integrative literature review. J Pediatr Nurs, 2018, 38: 74-80.
5. Yang S, Werner BC. Risk factors for prolonged postoperative opioid use after spinal fusion for adolescent idiopathic scoliosis. J Pediatr Orthop, 2018. [Epub ahead of print].
6. 谭岚月, 黄焜, 左云霞. 国内大型综合医院和儿童医院小儿术后镇痛调查. 国际麻醉学与复苏杂志, 2014, 35(12): 1109-1112, 1116.
7. Hayes J, Pehora C, Bissonnette B. The use of NSAIDs in pediatric scoliosis surgery-a survey of physicians’ prescribing practice. Paediatr Anaesth, 2009, 19(8): 756-763.
8. Jöbsis JJ, Alabbas A, Milner R, et al. Acute kidney injury following spinal instrumentation surgery in children. World J Nephrol, 2017, 6(2): 79-85.
9. Koch HJ. Pharmacotherapy aspects during Harrington’s method of spinal surgery. Soz Praventivmed, 1995, 40(4): 230-233.
10. 王芳, 朱慧英, 张军, 等. 静脉吗啡用于小儿矫形手术术后镇痛的研究. 临床麻醉学杂志, 2002, 18(3): 165-166.
11. Rosenberg RE, Trzcinski S, Cohen M, et al. The association between adjuvant pain medication use and outcomes following pediatric spinal fusion. Spine (Phila Pa 1976), 2017, 42(10): E602-E608.
12. Choudhry DK, Brenn BR, Sacks K, et al. Evaluation of gabapentin and clonidine use in children following spinal fusion surgery for idiopathic scoliosis: a retrospective review. J Pediatr Orthop, 2017. [Epub ahead of print].
13. Gornitzky AL, Flynn JM, Muhly WT, et al. A rapid recovery pathway for adolescent idiopathic scoliosis that improves pain control and reduces time to inpatient recovery after posterior spinal fusion. Spine Deform, 2016, 4(4): 288-295.
14. Rusy LM, Hainsworth KR, Nelson TJ, et al. Gabapentin use in pediatric spinal fusion patients: a randomized, double-blind, controlled trial. Anesth Analg, 2010, 110(5): 1393-1398.
15. Weldon BC, Connor M, White PF. Pediatric PCA: the role of concurrent opioid infusions and nurse-controlled analgesia. Clin J Pain, 1993, 9(1): 26-33.
16. Amaranath L, Andrish JT, Gurd AR, et al. Efficacy of intermittent epidural morphine following posterior spinal fusion in children and adolescents. Clin Orthop Relat Res, 1989, (249): 223-226.
17. Klatt JW, Mickelson J, Hung M, et al. A randomized prospective evaluation of 3 techniques of postoperative pain management after posterior spinal instrumentation and fusion. Spine (Phila Pa 1976), 2013, 38(19): 1626-1631.
18. Tobias JD, Gaines RW, Lowry KJ, et al. A dual epidural catheter technique to provide analgesia following posterior spinal fusion for scoliosis in children and adolescents. Paediatr Anaesth, 2001, 11(2): 199-203.
19. Erdogan MA, Ozgul U, Ucar M, et al. Patient-controlled intermittent epidural bolus versus epidural infusion for posterior spinal fusion after adolescent idiopathic scoliosis: prospective, randomized, double-blinded study. Spine (Phila Pa 1976), 2017, 42(12): 882-886.
20. Ibach BW, Loeber C, Shukry M, et al. Duration of intrathecal morphine effect in children with idiopathic scoliosis undergoing posterior spinal fusion. J Opioid Manag, 2015, 11(4): 295-303.
21. Tripi PA, Poe-Kochert C, Potzman J, et al. Intrathecal morphine for postoperative analgesia in patients with idiopathic scoliosis undergoing posterior spinal fusion. Spine (Phila Pa 1976), 2008, 33(20): 2248-2251.
22. Sethna NF, Berde CB. Continuous subarachnoid analgesia in two adolescents with severe scoliosis and impaired pulmonary function. Reg Anesth, 1991, 16(6): 333-336.
23. Hong RA, Gibbons KM, Li GY, et al. A retrospective comparison of intrathecal morphine and epidural hydromorphone for analgesia following posterior spinal fusion in adolescents with idiopathic scoliosis. Paediatr Anaesth, 2017, 27(1): 91-97.
24. Dahl JB, Kehlet H. The value of pre-emptive analgesia in the treatment of postoperative pain. Br J Anaesth, 1993, 70(4): 434-439.
25. Machida M, Imamura Y, Usui T, et al. Effects of preemptive analgesia using continuous subcutaneous morphine for postoperative pain in scoliosis surgery: a randomized study. J Pediatr Orthop, 2004, 24(5): 576-580.
26. Poe-Kochert C, Tripi PA, Potzman J, et al. Continuous intravenous morphine infusion for postoperative analgesia following posterior spinal fusion for idiopathic scoliosis. Spine (Phila Pa 1976), 2010, 35(7): 754-757.
27. 谢菡, 马正良, 陈正香, 等. 病人自控静脉镇痛在脊柱侧弯患者术后镇痛中的效果评价. 药学与临床研究, 2016, 24(2): 164-166.
28. Ravish M, Muldowney B, Becker A, et al. Pain management in patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion: combined intrathecal morphine and continuous epidural versus PCA. J Pediatr Orthop, 2012, 32(8): 799-804.
29. 张萍, 郑曼, 张媛, 等. 鞘内注射吗啡用于脊柱矫形术后镇痛. 临床麻醉学杂志, 2009, 25(12): 1062-1063.
30. Hong R, Gauger V, Caird MS, et al. Narcotic-only epidural infusion for posterior spinal fusion patients: a single-center, retrospective review. J Pediatr Orthop, 2016, 36(5): 526-529.
31. Hiller A, Helenius I, Nurmi E, et al. Acetaminophen improves analgesia but does not reduce opioid requirement after major spine surgery in children and adolescents. Spine (Phila Pa 1976), 2012, 37(20): E1225-E1231.
32. Chan CYW, Loo SF, Ong JY, et al. Feasibility and outcome of an accelerated recovery protocol in asian adolescent idiopathic scoliosis patients. Spine (Phila Pa 1976), 2017, 42(24): E1415-E1422.
33. Chidambaran V, Subramanyam R, Ding L, et al. Cost-effectiveness of intravenous acetaminophen and ketorolac in adolescents undergoing idiopathic scoliosis surgery. Paediatr Anaesth, 2018, 28(3): 237-248.
34. Kádas I, Könczöl F, Illés T. Fatal acute liver damage caused by a therapeutic dose of paracetamol. Orv Hetil, 1998, 139(4): 189-191.
35. Munro HM, Walton SR, Malviya S, et al. Low-dose ketorolac improves analgesia and reduces morphine requirements following posterior spinal fusion in adolescents. Can J Anaesth, 2002, 49(5): 461-466.
36. Horn PL, Wrona S, Beebe AC, et al. A retrospective quality improvement study of ketorolac use following spinal fusion in pediatric patients. Orthop Nurs, 2010, 29(5): 342-343.
37. Sucato DJ, Lovejoy JF, Agrawal S, et al. Postoperative ketorolac does not predispose to pseudoarthrosis following posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis. Spine (Phila Pa 1976), 2008, 33(10): 1119-1124.
38. Vitale MG, Choe JC, Hwang MW, et al. Use of ketorolac tromethamine in children undergoing scoliosis surgery. an analysis of complications. Spine J, 2003, 3(1): 55-62.
39. 张杜枭, 于锋, 葛卫红, 等. 不同剂量氟比洛芬酯联合芬太尼在脊柱侧凸矫形术术后镇痛作用比较. 药学与临床研究, 2015, 23(2): 182-184.
40. 徐学武, 李青波, 刘骥, 等. 地佐辛与氟比洛芬酯在脊柱侧弯患者术后镇痛中作用的比较. 中华临床医师杂志 (电子版), 2013, 7(13): 6155-6156.
41. 谢菡, 马正良, 陈正香, 等. 脊柱侧弯矫形术术后使用氟比洛芬酯注射液镇痛效果的影响因素分析. 药物流行病学杂志, 2018, 27(1): 10-13.
42. Kwan MK, Chiu CK, Chan TS, et al. Trajectory of postoperative wound pain within the first 2 weeks following posterior spinal fusion surgery in adolescent idiopathic scoliosis patients. Spine (Phila Pa 1976), 2017, 42(11): 838-843.
43. Jones JS, Cotugno RE, Singhal NR, et al. Evaluation of dexmedetomidine and postoperative pain management in patients with adolescent idiopathic scoliosis: conclusions based on a retrospective study at a tertiary pediatric hospital. Pediatr Crit Care Med, 2014, 15(6): e247-e252.
44. Samartzis D, Bow C, Cheung JP, et al. Efficacy of postoperative pain management using continuous local anesthetic infusion at the iliac crest bone graft site in patients with adolescent idiopathic scoliosis: a parallel, double-blinded, Randomized Controlled Pilot Trial. Global Spine J, 2016, 6(3): 220-228.
45. Reynolds RA, Legakis JE, Tweedie J, et al. Postoperative pain management after spinal fusion surgery: an analysis of the efficacy of continuous infusion of local anesthetics. Global Spine J, 2013, 3(1): 7-14.
46. Lowry KJ, Tobias J, Kittle D, et al. Postoperative pain control using epidural catheters after anterior spinal fusion for adolescent scoliosis. Spine (Phila Pa 1976), 2001, 26(11): 1290-1293.
47. Adu-Gyamfi Y. Epidural morphine plus bupivacaine for relief of post-operative pain following Harrington rod insertion for correction of idiopathic scoliosis. J Int Med Res, 1995, 23(3): 211-217.
48. Gauger VT, Voepel-Lewis TD, Burke CN, et al. Epidural analgesia compared with intravenous analgesia after pediatric posterior spinal fusion. J Pediatr Orthop, 2009, 29(6): 588-593.
49. Aĭzenberg VL, Ul’rikh GE, Ukolov KIu, et al. Methods of analgesia in children after surgical correction of the scoliotic spinal deformities. Anesteziol Reanimatol, 2011, (1): 59-62.
50. Cassady JF Jr, Lederhaas G, Cancel DD, et al. A randomized comparison of the effects of continuous thoracic epidural analgesia and intravenous patient-controlled analgesia after posterior spinal fusion in adolescents. Reg Anesth Pain Med, 2000, 25(3): 246-253.
51. Taenzer AH, Clark C. Efficacy of postoperative epidural analgesia in adolescent scoliosis surgery: a meta-analysis. Paediatr Anaesth, 2010, 20(2): 135-143.
52. Buck ML, Willson DF. Use of dexmedetomidine in the pediatric intensive care unit. Pharmacotherapy, 2008, 28(1): 51-57.
53. 姬乐婷, 张建辉. 不同剂量右美托咪定复合舒芬太尼在小儿脊柱侧弯矫正术术后镇痛效果的比较. 北方药学, 2018, 15(7): 7-9.
54. Aydogan MS, Korkmaz MF, Ozgül U, et al. Pain, fentanyl consumption, and delirium in adolescents after scoliosis surgery: dexmedetomidine vs midazolam. Paediatr Anaesth, 2013, 23(5): 446-452.
55. Thomas JJ, Levek C, Quick HD, et al. Utility of gabapentin in meeting physical therapy goals following posterior spinal fusion in adolescent patients with idiopathic scoliosis. Paediatr Anaesth, 2018, 28(6): 558-563.
56. Mayell A, Srinivasan I, Campbell F, et al. Analgesic effects of gabapentin after scoliosis surgery in children: a randomized controlled trial. Paediatr Anaesth, 2014, 24(12): 1239-1244.

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