Efficacy of a local anesthetic pain pump in abdominoplasty

BACKGROUND: Recently, pain infusion pumps for postoperative pain control have gained popularity in many surgical specialties. This investigation was designed to evaluate the efficacy of a local anesthetic pain infusion pump in management of postoperative pain in abdominoplasty patients. METHODS: A retrospective study of 38 abdominoplasty patients with local anesthetic pain pumps and 35 abdominoplasty patients without pain pumps was performed. Pain pumps were loaded with 0.25% or 0.5% bupivacaine and infused at a constant rate of 4 ml/hour. All patients were admitted postoperatively and started on a narcotic patient-controlled analgesia. Postoperative patient-controlled analgesia narcotic use and pain scores were recorded every 2 hours by the nursing staff. For the first 24 hours of postoperative hospital stay, pain medication, pain scores, and antiemetic use were determined from the patients' charts. Hospital stay was also reviewed. RESULTS: In the pain pump group, there was a small but not statistically significant reduction in pain medication use (2.65 versus 3.04 pain units) (p = 0.34). Interestingly, pain scores were higher in the pain pump group but not significantly (2.73 versus 2.31) (p = 0.17). There was no statistically significant difference in the use of antiemetics (0.8 versus 0.6) (p = 0.60). Hospital length of stay averaged 2.2 days in the pain pump group and 2.5 days in the group without pain pumps (p = 0.09). CONCLUSIONS: The postoperative use of pain pumps in abdominoplasty patients does not significantly improve pain management. Further investigation into this application of the pain pump is necessary before recommending their routine use in abdominoplasty patients.