Anesthesia pouch gets kids home sooner after surgery

NEW YORK (Reuters Health) - Children recovering from orthopedic surgery feel less pain and leave the hospital sooner when they go home with a small anesthetic pouch that delivers a local numbing medication.

The anesthesia pouch, already used in adults, is safe, effective, and feasible for use in children, doctors at Children's Hospital of Philadelphia report based on the outcomes of 217 children who used this pain management technique after orthopedic surgery.

"Since the implementation of the program, it has been possible to discharge children home who would have otherwise been hospitalized for at least 24 hours to manage postoperative pain after (orthopedic) operations," they note in the in the medical journal Anesthesia and Analgesia.

Once the child leaves the hospital, a small anesthesia pouch attached to a belt worn over the shoulder or around the waist delivers local numbing medication to the affected limb via a catheter. Patients receive daily visits from a home nurse until the catheter is removed. Parents can take out the catheter themselves at home, avoiding another trip to the hospital.

In the current group of children, the average length of anesthetic infusion was about 48 hours. The overall failure rate was relatively low (15 percent), as was the incidence of nausea and vomiting (14 percent), the clinicians report.

The in-home anesthesia pouch for pain management "has never been done routinely in pediatrics," Dr. Arjunan Ganesh, a pediatric anesthesiologist at Children's Hospital, said in a statement. "I don't know of any other institution that regularly sends children home with catheters. They may be starting to do it now, after we have shown in studies that it works."

SOURCE: Anesthesia and Analgesia, November 2007.