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

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.