Minimizing the need for high dependency unit support in adolescent idiopathic scoliosis surgery. Is enhanced recovery and the multidisciplinary team key?

Journal of Pediatric Orthopedics. Part B
Debashis DassJayesh M Trivedi

Abstract

Current trends in the surgical treatment of patients with adolescent idiopathic scoliosis (AIS) involve the use of high dependency unit (HDU) in the postoperative period. The British Scoliosis Society also recommends the availability of HDU support in the postoperative period for these patients. However, this practice may lead to unexpected theatre cancellations due to lack of availability of HDU bed on the day of surgery. We also hypothesize that this practice may eventually lead to longer inpatient stay for the patients. All AIS patients at our unit are managed on a paediatric ward postoperatively, without HDU support. The primary aim of the study therefore is to evaluate whether operating on AIS patients without HDU support is well tolerated practice. Secondary aims were to evaluate patient related outcomes, including length of stay (LOS), and postoperative analgesia requirements. Adolescents aged 12-17 years with idiopathic scoliosis deformity who were treated with posterior instrumented scoliosis (PIS) correction were included in this prospective cohort study. The study period was between 12 November 2012 and 6 August 2018. Twenty-two patients were included in the HDU group and 33 patients in the non-HDU group. These were ...Continue Reading

References

Nov 19, 1994·Lancet·J E Lonstein
Jul 25, 2008·Annals of Surgery·Henrik Kehlet, Douglas W Wilmore
Jul 21, 2009·Current Opinion in Critical Care·Henrik Kehlet
Apr 27, 2010·Anesthesia and Analgesia·Lynn M RusySteven J Weisman
Nov 23, 2011·Anesthesia and Analgesia·Daphne MicheletSouhayl Dahmani
Apr 3, 2016·Best Practice & Research. Clinical Anaesthesiology·Thomas W WainwrightRobert G Middleton
Apr 22, 2020·Global Spine Journal·Sagar A ShahMichael J Heffernan

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