ON-Q anesthetic pump in gynecologic oncology: feasibility study of a novel placement technique at an army hospital.
OBJECTIVE
The goals were (1) to describe a novel placement technique for the ON-Q anesthetic system based on somatic neural anatomy and (2) to determine its feasibility, efficacy, and associated morbidity among surgical patients on a gynecologic oncology service.


METHODS
A retrospective observational study of 100 consecutive patients who underwent a vertical laparotomy and received an ON-Q system was performed. The ON-Q system was composed of a soaker catheter (threaded longitudinally within the rectus sheaths) and an elastomer pump that infused 0.5% bupivacaine at 2 mL/hour for up to 5 days.


RESULTS
The average duration of ON-Q system use was 4.4 days (range, 2-5 days). The median numeric pain scores (range, 0-10) were 3, 2, 1, 0, and 0 on postoperative days 1, 2, 3, 4, and 5, respectively. Complications encountered included suturing of the catheter to the fascia (n = 1), wound hematomas (n = 2), and device failure (n = 1).


CONCLUSIONS
Intrafascial placement of the ON-Q soaker catheter for bupivacaine infusion appears effective for incisional analgesia, with negligible wound morbidity and device failure rates.
Shen-Gunther
Jane
J
Naval Medical Center San Diego, San Diego, CA 92134-6200, USA.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D005240:Feasibility Studies; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006772:Hospitals, Military; D006801:Humans; D015918:Infusion Pumps, Implantable; D008485:Medical Audit; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D012189:Retrospective Studies
D000779:Anesthetics, Local; D002045:Bupivacaine