Pain Management in Pectus Excavatum Surgery: A Comparison of Subcutaneous Catheters Versus Epidurals in a Pediatric Population
| Autor: | Shefali Thaker, Meghna V. Misra, Christine Rader, Elise McKenna |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Catheters Adolescent Infusions Subcutaneous 03 medical and health sciences 0302 clinical medicine Pectus excavatum Pain control medicine Humans Pain Management Infusion Pumps Pain Measurement Retrospective Studies Analgesics Pain Postoperative business.industry Pain management Surgical correction Length of Stay medicine.disease Surgery Analgesia Epidural 030220 oncology & carcinogenesis Funnel Chest 030211 gastroenterology & hepatology Female business Pediatric population |
| Zdroj: | Journal of laparoendoscopicadvanced surgical techniques. Part A. 29(2) |
| ISSN: | 1557-9034 |
| Popis: | Pectus excavatum is a common chest wall anomaly. Achieving optimal pain control is a priority for adolescents undergoing surgical correction of this condition. Options for pain control include the use of subcutaneous catheters (On-QWe identified patients who underwent pectus excavatum repair at our institution between January 2010 and August 2016. Patients were divided into two cohorts (epidural or On-Q pump). Patient charts were reviewed for length of stay, pain scores, pain medications, and complications.A total of 124 patients were included. Forty percent of patients used an epidural (n = 50), and 60% had the On-Q pump (n = 74). The average patient age was 15.6 years. The average Haller index was 4.3. The On-Q pump population had a significant decrease in postoperative length of stay (mean [M] = 4.86, standard deviation [SD] = 0.85) compared with the epidural population (M = 5.60, SD = 0.97); P ≤ .001. There was a significant difference observed in pain scores for patients on the epidural (M = 2.91, SD = 1.13) and On-Q pump (M = 3.81, SD = 1.19; P ≤ .001). There was n = 1 wound infection in each group.The use of bilateral subcutaneous infusion catheters is a safe and effective method for pain control in patients undergoing surgical correction of pectus excavatum. Even though the degree of pain control is not necessarily superior to epidurals, in this study, the catheters were associated with a shorter postoperative length of stay in this patient population and did not increase the incidence of complications. |
| Databáze: | OpenAIRE |
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