title: On-Q ® pain pump versus epidural for postoperative analgesia in children.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  The On-Q(®) pain pump is an effective method for postoperative pain control, without the inherent risks of epidural catheters.
authors.affiliation: Department of Pediatric Surgery, Children's Hospital Los Angeles, 4650 W. Sunset Blvd, Mailstop #100, Los Angeles, CA, 90027, USA, epontarelli@chla.usc.edu.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Pontarelli
authors.forename: Jamil A
authors.initials: JA
authors.lastname: Matthews
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Goodhue
authors.forename: James E
authors.initials: JE
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D015360:Analgesia, Epidural / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000704:Analysis of Variance; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007260:Infusion Pumps; D008297:Male; D010147:Pain Measurement / Q000379:methods / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D005283:Fentanyl; D002045:Bupivacaine