title: The ON-Q pain management system in elective gynecology oncologic surgery: Management of postoperative surgical site pain compared to intravenous patient-controlled analgesia.
abstract: OBJECTIVE
  The goal of this study was to compare postoperative surgical site pain in gynecologic cancer patients who underwent elective extended lower midline laparotomy and managed their pain with either the ON-Q pain management system (surgical incision site pain relief system, ON-Q pump) or an intravenous patient-controlled analgesia pump (IV PCA).
  
  
  METHODS
  Twenty gynecologic cancer patients who underwent elective extended lower midline laparotomy were divided into two groups. One group received a 72-hour continuous wound perfusion of the local anesthetic ropivacaine (0.5%, study group) into the supraperitoneal layer of the abdominal incision through the ON-Q pump. The other group received intravenous infusion pump of patient-controlled analgesia (fentanyl citrate 20 mg/mL · kg+ondansetron hydrochloride 16 mg/8 mL+normal saline). Postoperative pain was assessed immediately and at 6, 24, 48, 72, and 96 hours after surgery using the visual analogue scale.
  
  
  RESULTS
  Postoperative surgical site pain scores at 24, 48, and 72 hours after surgery were lower in the ON-Q group than the IV PCA group. Pain scores at 24 hours and 48 hours after surgery were significantly different between the two groups (P=0.023, P<0.001). Overall painkiller administration was higher in the ON-Q group but this difference was not statistically significant (5.1 vs. 4.3, P=0.481).
  
  
  CONCLUSIONS
  This study revealed that the ON-Q pain management system is a more effective approach than IV PCA for acute postoperative surgical site pain relief after extended lower midline laparotomy in gynecologic cancer patients.
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.
authors: Dawn
authors: D
authors: Chung
authors: Yoo Jin
authors: YJ
authors: Lee
authors: Mi Hyun
authors: MH
authors: Jo
authors: Hyun Jong
authors: HJ
authors: Park
authors: Ga Won
authors: GW
authors: Lim
authors: Hanbyoul
authors: H
authors: Cho
authors: Eun Ji
authors: EJ
authors: Nam
authors: Sang Wun
authors: SW
authors: Kim
authors: Jae Hoon
authors: JH
authors: Kim
authors: Young Tae
authors: YT
authors: Kim
authors: Sunghoon
authors: S
authors: Kim
keywords: Analgesia; Gynecologic neoplasm; Local anesthesia; Postoperative pain