Cranio-cervical instability (CCI) has been well identified in diseases regarding connective tissue, such as Ehlers-Danlos Syndrome/Hipermobility Type (EDS-HT). These patients frequently suffer from severe widespread pain with very difficult management and control. Chronic neuroinflamation, opioid-induced hyperalgesia, and central sensitization phenomena may explain this complex painful condition. A retrospective, observational, consecutive case series study is designed to determine if opioid-free anesthetic management shows a reduction in postoperative pain and opioid rescues needs in comparison with opioid-based anesthesia management for patients with EDS-HT undergoing crano-cervical fixation.
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Age
Timeframe: Baseline
Sex
Timeframe: Baseline
PO Analgesia
Timeframe: Baseline
Preoperative EVA
Timeframe: Baseline
Preoperative Opioids
Timeframe: Baseline
Postoperative EVA 1
Timeframe: 1 day after surgery
Postoperative EVA 2
Timeframe: 2 days after surgery
Postoperative EVA 4
Timeframe: 4 days after surgery
Postoperative EVA 6
Timeframe: 6 days after surgery
Sufentanil doses 1
Timeframe: From surgery release till first day of hospitalization
Sufentanil doses 2
Timeframe: From first day of hospitalization till second day of hospitalization
Sufentanil doses 4
Timeframe: From second day of hospitalization till fourth day of hospitalization
Sufentanil doses 6
Timeframe: From fourth day of hospitalization till sixth day of hospitalization
Rescue Methadone
Timeframe: Baseline
Morphine dosage 1
Timeframe: From surgery release till first day of hospitalization
Morphine dosage 2
Timeframe: From first day of hospitalization till second day of hospitalization
Morphine dosage 4
Timeframe: From second day of hospitalization till fourth day of hospitalization
Morphine dosage 6
Timeframe: From fourth day of hospitalization till sixth day of hospitalization
Nausea and vomiting
Timeframe: Baseline
Intestinal ileus
Timeframe: Baseline
Constipation
Timeframe: Baseline
Anxiolytic rescue agent
Timeframe: Baseline
Oral ketamine
Timeframe: Baseline
Chronic opioid and hospital discharge
Timeframe: Up to 6 days