Literature DB >> 23860616

On-Q ® pain pump versus epidural for postoperative analgesia in children.

Elizabeth M Pontarelli1, Jamil A Matthews, Catherine J Goodhue, James E Stein.   

Abstract

PURPOSE: The On-Q(®) pain pump provides a continuous infusion of local anesthesia for management of postoperative pain. The objective of this study was to assess the efficacy and outcomes of the On-Q(®) pump compared to continuous epidural in children postoperatively.
METHODS: We performed a retrospective review of patients in our hospital who received a postoperative epidural or On-Q(®) pump from 2005 to 2008. Patients were sub-categorized by incision type.
RESULTS: Seventy patients received epidural and 66 On-Q(®). On-Q(®) therapy was longer by 1 day (p < 0.0001), but did not affect postoperative length of stay. Patients with On-Q(®) pumps had a decreased rate of Foley catheter placement (p = 0.002) and shorter duration of catheter use by more than a day (p < 0.001). Moderate to severe pain was similar in the two groups on postoperative days 0-5. Supplemental narcotic use was higher in the On-Q(®) group only on postoperative day 1 (p = 0.005) and in patients with midline and transverse abdominal incisions. No differences were seen in time to ambulation or recovery of postoperative ileus.
CONCLUSION: The On-Q(®) pain pump is an effective method for postoperative pain control, without the inherent risks of epidural catheters.

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Year:  2013        PMID: 23860616     DOI: 10.1007/s00383-013-3342-4

Source DB:  PubMed          Journal:  Pediatr Surg Int        ISSN: 0179-0358            Impact factor:   1.827


  18 in total

Review 1.  Incidence of epidural hematoma, infection, and neurologic injury in obstetric patients with epidural analgesia/anesthesia.

Authors:  Wilhelm Ruppen; Sheena Derry; Henry McQuay; R Andrew Moore
Journal:  Anesthesiology       Date:  2006-08       Impact factor: 7.892

2.  Experience of lumbar epidural insertion in 573 anesthetized patients.

Authors:  Kiyoshi Terasako
Journal:  J Anesth       Date:  2011-09-14       Impact factor: 2.078

3.  Improved pain management outcomes with continuous infusion of a local anesthetic after thoracotomy.

Authors:  Grayson H Wheatley; David H Rosenbaum; Michelle C Paul; Alan P Dine; Michael A Wait; Dan M Meyer; Michael E Jessen; W Steves Ring; J Michael DiMaio
Journal:  J Thorac Cardiovasc Surg       Date:  2005-08       Impact factor: 5.209

4.  Epidural versus subcutaneous administration of alfentanil for the management of postoperative pain.

Authors:  J Chrubasik; S Chrubasik; Y Ren; J Schulte-Mönting; E Martin
Journal:  Anesth Analg       Date:  1994-06       Impact factor: 5.108

5.  Continuous subcutaneous infusion of morphine for postoperative pain relief.

Authors:  T A Goudie; M W Allan; M Lonsdale; L M Burrow; W A Macrae; I S Grant
Journal:  Anaesthesia       Date:  1985-11       Impact factor: 6.955

6.  Comparison of the On-Q Painbuster Post-Op Pain Relief System to a thoracic epidural for control of postoperative thoracotomy pain in a child.

Authors:  Sally E Rampersad; Jonathan C Rowell; Benjamin M Chang
Journal:  Paediatr Anaesth       Date:  2009-10       Impact factor: 2.556

7.  Continuous incisional infusion of local anesthetic in pediatric patients following open heart surgery.

Authors:  Christopher F Tirotta; Hamish M Munro; Jane Salvaggio; Danielle Madril; Donald E Felix; Lynda Rusinowski; Cristi Tyler; William Decampli; Robert L Hannan; Redmond P Burke
Journal:  Paediatr Anaesth       Date:  2009-06       Impact factor: 2.556

Review 8.  Protective effects of epidural analgesia on pulmonary complications after abdominal and thoracic surgery: a meta-analysis.

Authors:  Daniel M Pöpping; Nadia Elia; Emmanuel Marret; Camille Remy; Martin R Tramèr
Journal:  Arch Surg       Date:  2008-10

9.  Continuous subcutaneous infusion of morphine--an alternative to extradural morphine for postoperative pain relief.

Authors:  K B Hindsholm; C Bredahl; M K Jensen; L Kidmose; P Herlevsen; F B Nielsen; A S Olesen
Journal:  Br J Anaesth       Date:  1993-10       Impact factor: 9.166

10.  Effects of preemptive analgesia using continuous subcutaneous morphine for postoperative pain in scoliosis surgery: a randomized study.

Authors:  Masafumi Machida; Yasuhide Imamura; Takeo Usui; Tohru Asai
Journal:  J Pediatr Orthop       Date:  2004 Sep-Oct       Impact factor: 2.324

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