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Elastomeric pain pumps used after pediatric scoliosis surgery led to improved outcomes
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SAN DIEGO — When elastomeric pain pumps, methocarbamol and gabapentin were used after
scoliosis surgery in adolescents, it was associated with improved outcomes, a presenter said at the American Academy of Orthopaedic Surgeons Annual Meeting.
“[Multimodal] pain regimen will decrease the length of stay compared with just the traditional pain control method,” Hilda H. Kriel, MD, said in her presentation. “Elastomeric pain pumps may act in conjunction with other multimodal pain medications to reduce both postoperative pain and length of stay, and our rate of infection. And, our rate of postoperative gastric retention decreased over time.”
Kriel and colleagues performed a retrospective chart review over a 7-year period of 81 adolescents who underwent surgery for scoliosis. She said as their practice changed, 12 patients were given IV opioids with oral opioids, 28 patients were given 3-day elastomeric pain pumps which used 270 mL of 0.125 bupivacaine. Investigators added multimodal pain management, which included gabapentin and methocarbamol, in 41 patients.
When Kriel and colleagues analyzed the outcomes for the length of stay (LOS), infection rate and postoperative bowel retention, they found they were not significantly different based on the patients’ age, sex and neurogenic status.
The LOS was 8.2 days for patients treated with opioids, 5.2 days for patients who used elastomeric pain pumps and 4.8 days for patients treated with multimodal pain management. On average, the LOS in the opioid group was 3.1 days more than for the pain pump group and 4.3 days more than for the multimodal pain treatment group.
In addition, the infection rate decreased from 25% to 0% at 3 months in the pain pump group. There was also a significant decrease in the incidence of postoperative bowel retention — from 25% to 2%, Kriel noted. – by Monica Jaramillo
Reference:
Kriel HH, et al. Paper #105. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 14-18, 2017; San Diego.
Disclosure: Kriel reports no relevant financial disclosures.