Opioid consumption and bowel dysfunction in adolescents after spinal surgery.

The study, outlined in this article, aimed to ascertain the effect of length of surgery and opioid consumption on length of stay and bowel dysfunction, and to review current post-operative bowel practices. A retrospective case note review was carried out of all patients with a diagnosis of adolescent idiopathic scoliosis (n=44) who had undergone a posterior spinal fusion between January 2012 and May 2014. Mean length of surgery was 3:24 hours (±0:40 hours), while average length of stay was 6 days (mean 6.27 days ±2.39). Average opioid consumption post-operatively was 152.15mg (±60.95mg). There were no statistically significant associations. Some form of laxative was received by 93% of (n=41) patients. Of those, 20 required an enema before discharge. This was most commonly administered on post-operative days four and five (65%). This service evaluation demonstrated that length of surgery and amount of opioid have no significant effect on length of stay for young people following a posterior spinal fusion. It is suggested that lactulose and senna are given in combination at doses as per the British National Formulary for Children starting on post-operative day two, which should avoid the need to administer an enema.

An overview of infantile hypertrophic pyloric stenosis.

In paediatric general surgery hypertrophic pyloric stenosis (HPS) is well-researched and documented (Dudgeon 2005, Panteli 2009). Significant medical advances have improved its diagnosis, treatment and prognosis, and there is now almost a 100 per cent success rate (Panteli 2009). However, the cause of this disease process remains poorly understood (Dudgeon 2005, Panteli 2009). This article reviews the literature on the cause and management of HPS.