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An Update on Pain Management in Pediatric Spine Surgery.
Sara N Kiani1, Katherine Bach1, Vivian Kwok2
1Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, 94143, USA.
Current Reviews in Musculoskeletal Medicine
|May 31, 2026
Summary
Effective perioperative pain control in pediatric spine surgery involves multimodal strategies. Regional anesthesia and addressing psychosocial factors are key to reducing opioid use and improving patient recovery.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pain Management
Background:
- Pediatric pain management is crucial for reducing postoperative complications, enhancing early mobilization, and minimizing opioid dependence.
- Preoperative mental health influences postoperative pain levels, highlighting the need for a holistic approach.
Purpose of the Study:
- To review current recommendations for perioperative pain management in pediatric spine surgery.
- To summarize data on preoperative, intraoperative, and postoperative pain management strategies.
Main Methods:
- Review of current literature and recommendations for pediatric spine surgery pain control.
- Analysis of preoperative, intraoperative, and postoperative pain management pathways.
Main Results:
- Preoperative mental health conditions correlate with increased postoperative pain.
- Intravenous ketorolac and oral gabapentin improve postoperative pain control and decrease opioid consumption.
- Regional anesthesia modalities (e.g., erector spinae plane blocks, liposomal bupivacaine) and neuraxial techniques show promise for earlier mobilization and reduced opioid use.
- Multimodal pain control, aligned with Enhanced Recovery After Surgery protocols, is essential for managing pain and side effects.
- Psychosocial factors, such as anxiety, significantly impact pain perception and outcomes.
Conclusions:
- Multimodal pain management integrating regional anesthesia and addressing psychosocial factors is recommended for pediatric spine surgery.
- Further research is needed to compare regional modalities and explore interventions for psychosocial factors influencing pain.
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