Pediatric postoperative pain of scoliosis correction surgery successfully treated with pregabalin: a case report

Abstract

Background: Pain after scoliosis correction surgery is severe. Pain management is difficult, especially in children. Case: An 11-year-old female underwent scoliosis correction surgery. In addition to postoperative wound pain, numbness and pain in the right chest and axilla suggested neuropathic pain. She received fentanyl intravenous patient-controlled analgesia (IVPCA) for pain management. On the 5th postoperative day, she refused to discontinue IVPCA. Due to fear, she refrained from touching and washing her hair. Therefore, although it was an off-label use for children, we administered pregabalin in order to discontinue IVPCA. Afterwards, she was able to change her posture and begin rehabilitation. Discussion: In Japan, only a few oral analgesic types are considered usable for children, and opioids are contraindicated. Postoperative pain after spinal surgery is a mixture of nociceptive and neuropathic pain. Thus, pregabalin is effective for managing postoperative pain associated with scoliosis in children.