Opioid consumption and bowel dysfunction in adolescents after spinal surgery

Area of Science:

• Orthopedics
• Pediatric Surgery
• Gastroenterology

Background:

• Adolescent idiopathic scoliosis (AIS) is a common spinal deformity.
• Posterior spinal fusion is a major surgical intervention for AIS.
• Postoperative bowel dysfunction and length of stay are significant concerns.

Purpose of the Study:

• To evaluate the impact of surgery duration and opioid consumption on length of stay and bowel function in AIS patients.
• To review current post-operative bowel management practices.
• To identify strategies for improving patient recovery and reducing complications.

Main Methods:

• Retrospective case note review of 44 AIS patients who underwent posterior spinal fusion.
• Analysis of surgery length, opioid consumption, length of hospital stay, and bowel dysfunction.
• Review of post-operative bowel care protocols and interventions.

Main Results:

• Mean surgery length was 3.4 hours; average hospital stay was 6.3 days; average opioid consumption was 152.15mg.
• No statistically significant association found between surgery length/opioid consumption and length of stay or bowel dysfunction.
• 93% of patients received laxatives, with 20 requiring enemas, often on post-operative days 4-5.

Conclusions:

• Surgery length and opioid dosage do not significantly affect length of stay in AIS patients post-spinal fusion.
• Routine administration of lactulose and senna from post-operative day two is recommended.
• This proactive approach may reduce the need for enemas and improve bowel recovery.