Children who have had major urological procedures benefited postoperatively from locally infused anesthetics delivered using the ON-Q pain relief system, researchers from the Children’s Hospital of Orange County say.
The results, published in the Journal of Pediatric Urology, also showed that the kids experienced less postoperative pain, needed fewer narcotic interventions and enjoyed a shortened recovery time.
A total of 40 children were chosen for the study, all of whom were undergoing major urological operations.
The children were divided into two groups, one of which received the standard postoperative treatment of intravenous and oral analgesics. The remaining 20 children were treated using the ON-Q system.
The system delivers a continuous infusion of local anesthetic directly into the surgical wound, via a catheter. The catheter is designed to be “leaky” so the flow of anesthetic can cover a large area. And because it is an automatic and continuous supply, there is no need for caregivers to adjust the dosage.
Staff nurses assessed the children’s experience of pain using the Visual Analog Scale (VAS) or Face, Legs, Activity, Cry, Consolability Scale (FLACC), depending on the child’s age.
Analgesic consumption was recorded together with recovery parameters, such as temperature, start of oral nutrition and length of hospital stay.
The researchers found that patients treated using the ON-Q system experienced less pain on the first day after the operation (3 vs. 5.2) and trended toward the lower mean of the pain score on the subsequent day (1.8 vs. 3.5).
The researchers did not observe any difference in the frequency of fevers, start of oral nutrition or length of stay in the hospital between the two groups.
The ON-Q system is small enough to be carried in a pouch, enabling the children to move freely as they recovered.
Dr. Antoine E. Khoury, study investigator and chief of pediatric urology at the Children’s Hospital of Orange County, explains:
“While pain management is a fundamental part of pediatric surgical recovery and care for pediatric patients, current options involve strong prescription painkillers that can put patients at risk for adverse side effects and possible complications. This study demonstrates a major advancement in pain management for pediatric urology patients, significantly reducing postoperative pain and the need for pain medicine.”
The researchers note that while the ON-Q system has a proven track record of effective pain management in adults, this is the first study to test its effects on children.
The study concludes:
“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.”
However, the researchers call for additional clinical studies to further validate their findings and establish the technique as a “superior option for postoperative pain management in children undergoing surgery.”