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Research ArticleNew Technology

Thoracolumbar Dorsal Ramus Nerve Block Using Continuous Multiorifice Infusion Catheters: A Novel Technique for Postoperative Analgesia After Scoliosis Surgery

JEFF L. XU, VICTOR TSENG, DAMON DELBELLO and MATTHEW A. PRAVETZ
International Journal of Spine Surgery April 2020, 14 (2) 222-225; DOI: https://doi.org/10.14444/7024
JEFF L. XU
1Division of Regional Anesthesia and Acute Pain Management, Department of Anesthesiology, Westchester Medical Center/New York Medical College, Valhalla, New York
MD
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  • For correspondence: jeff.xu@wmchealth.org
VICTOR TSENG
1Division of Regional Anesthesia and Acute Pain Management, Department of Anesthesiology, Westchester Medical Center/New York Medical College, Valhalla, New York
MD
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DAMON DELBELLO
2Department of Orthopedic Surgery, Westchester Medical Center/New York Medical College, Valhalla, New York
MD
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MATTHEW A. PRAVETZ
3Department of Cell Biology and Anatomy, New York Medical College, Valhalla, New York
PHD
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ABSTRACT

Background: This is a brief technical report about a novel regional anesthesia technique in which local anesthetic was deposited around the thoracolumbar dorsal rami nerves via 4 multiorifice pain catheters to obtain analgesia for posterior spinal fusion surgery on scoliosis patients. Scoliosis is the most common deformity of the spine. Currently, most surgeons prefer a dual rod, segmental spinal fixation system that allows multiple anchor points for attachment to the deformed spine. Scoliosis surgery is an extremely painful surgical procedure due to the large incision, surgical trauma to superficial and deep muscles of the back, and the insertion of pedicle screws and metal rods directly into the vertebral column. Postoperative pain management remains very challenging.

Methods: Three patients presented with scoliosis. Intraoperatively, 4 multiorifice catheters were placed lateral to the implanted pedicle screws. Two catheters were placed on each side, and a continuous infusion of 0.2 % ropivacaine was initiated postoperatively to improve the patient's pain control. The catheters remained in place for 48 hours postoperatively and were removed by the surgical team. Gentle traction was applied similar to the way epidural catheters are removed.

Results: All 3 patients reported very low pain scores, low doses of opioid consumption, and satisfaction with their pain control throughout their hospitalization.

Conclusions: Our study results suggest that a thoracolumbar dorsal ramus nerve block using continuous multiorifice infusion catheters significantly improved postoperative comfort and pain and that its implementation into a multimodal analgesic regimen is relatively easy to achieve.

  • thoracolumbar dorsal ramus nerve block
  • multiorifice pain catheters
  • scoliosis surgery
  • posterior spinal fusion surgery
  • postoperative pain management

Footnotes

  • Disclosures and COI: The authors declare no conflict of interest; there are no financial or funding source(s) that support this work. Written informed consent was obtained from the patients for publication of this brief technical report and any accompanying images.

  • ©International Society for the Advancement of Spine Surgery
  • This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2020 ISASS.
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International Journal of Spine Surgery
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1 Apr 2020
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Thoracolumbar Dorsal Ramus Nerve Block Using Continuous Multiorifice Infusion Catheters: A Novel Technique for Postoperative Analgesia After Scoliosis Surgery
JEFF L. XU, VICTOR TSENG, DAMON DELBELLO, MATTHEW A. PRAVETZ
International Journal of Spine Surgery Apr 2020, 14 (2) 222-225; DOI: 10.14444/7024

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Thoracolumbar Dorsal Ramus Nerve Block Using Continuous Multiorifice Infusion Catheters: A Novel Technique for Postoperative Analgesia After Scoliosis Surgery
JEFF L. XU, VICTOR TSENG, DAMON DELBELLO, MATTHEW A. PRAVETZ
International Journal of Spine Surgery Apr 2020, 14 (2) 222-225; DOI: 10.14444/7024
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  • Feasibility and Analgesic Efficacy of Thoracolumbar Dorsal Ramus Nerve Block Using Multiorifice Pain Catheters for Scoliosis Surgery: A Prospective Cohort Study
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Keywords

  • thoracolumbar dorsal ramus nerve block
  • multiorifice pain catheters
  • scoliosis surgery
  • posterior spinal fusion surgery
  • postoperative pain management

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