O2129: Designated Spine Anesthesia Teams Improve Perioperative Efficiency for Complex Scoliosis

Background: In June 2020, our institutional policy changed, assigning only a designated team of anesthesiologists to all spinal deformity surgery. We hypothesized that Designated Spine Anesthesia Teams (DSATs) would demonstrate greater efficiency in caring for complex scoliosis cases.

Methods: All pediatric patients who underwent a spinal fusion between June 2016 to June 2024 with a planned postoperative stay in the intensive care unit (ICU) were included in our retrospective analysis. This comprised 4 years before and after DSAT implementation.

Results: We identified 204 patients over an eight-year period (88 patients pre-DSAT implementation and 116 patients post-DSAT implementation), the implementation of a DSAT led to significant enhancements in surgical efficiency and perioperative process measures. There was a notable reduction in total anesthesia time, which diminished by an average of 27.4 minutes per case. Intraoperative management was also affected with the mean allogenic blood transfusion volume in the post-DSAT cohort approximately half that of the pre-DSAT cohort (343cc vs 632cc). Post DSAT patients were more likely to be extubated in the OR (75.0% vs 54.9%). Demographics, preoperative radiographic findings and types of procedures performed and postoperative complications and re-admissions were not significantly different between the two cohorts.

Conclusion: DSATs significantly enhance the intraoperative delivery of care for pediatric patients with neuromuscular scoliosis. DSATs cultivate a deeper familiarity with the intraoperative needs of a certain cohort of patients resulting in improved predictability and standardization.