Abstract
Objectives
To determine the efficacy of the locally infused anesthetic, ON-Q® pain relief system (Kimberly–Clarke, GA–USA), in improving postoperative pain, reducing
narcotic requirement, and shortening recovery time after major pediatric urological
surgery.
Material and methods
A case–control analysis comparing 20 patients undergoing major urological procedures
who were treated postoperatively with the ON-Q system was compared to 20 patients
treated with current hospital standard of care intravenous and oral analgesics. Pain
was assessed in both groups by staff nurses using the different validated scales depending
on the child's age. Information regarding analgesic consumption along with recovery
parameters such as temperature, start of oral nutrition, and length of hospitalization
(LOH) were collected.
Results
The ON-Q group experienced significantly lower ratings of maximal pain on the first
postoperative day as compared to the control group (3 vs. 5.2, p = 0.03) and a trend toward lower mean of maximal pain score on postoperative day
two (1.8 vs. 3.5, p = 0.055). Systemic intravenous and oral analgesics were significantly lower on the
day of surgery and the first postoperative day for the ON-Q group (p = 0.014; and p = 0.046 respectively). No differences in frequency of fever, start of oral nutrition
and LOH were found between the study groups.
Conclusion
Continuous incisional infusion of local anesthetic with the ON-Q system is a viable
option for postoperative pain management in children undergoing major urological surgeries.
This technology significantly decreases the need for systemic analgesic consumption.
Keywords
Abbreviations:
VAS (visual analog scale), FLACC (Face, Legs, Activity, Cry, Consolability Scale), LOH (length of hospitalization)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 25, 2013
Accepted:
January 2,
2013
Received:
September 10,
2012
Identification
Copyright
© 2013 Journal of Pediatric Urology Company. Published by Elsevier Inc. All rights reserved.
