Multymodal approach for perioperational period management in patients with scoliosis
The article presents finding about preoperative preparation, perioperative and postoperative analgesia using epidural blockage in adolescents undergoing scoliosis correction surgery. 80 patients were included in study. Patient's ages ranged between 12 and 23 years. Patients were divided into three groups according to analgesia. Epidural anesthesia using before ventral and dorsal spinal fusion with 0,75% ropivacaine in both groups. In addition we used general anesthesia with propofol (1 group, n=26) or sevoflurane (2 group, n=30). Total intravenous anesthesia of propofol, fentanyl, clonidin was used in the control group (n=24). Epidural analgesia using continuous infusion of 0,2% ropivacaine as postoperative analgesia was used in 1 group and in 2 group we used 0,2% ropivacaine with fentanyl (1 mcg/ml) and adrenaline (2 mcg/ml). The good effect of combined epidural analgesia in patients of the 2 group and also advantage of regional analgesia with 0,2% ropivacaine with fentanyl + adrenaline are pointed out. Postoperative nausea and vomiting occurred significantly less frequently 40% and was reduced blood loss 50% in the epidural group.