Bupivacaine for Wound Infusion

Abstract

Objective: To determine if preperitoneal placement of continuously infusing bupivacaine catheters via the ON-Q PainBuster System® (I-Flow Corporation, Lake Forest, CA) results in decreased postoperative narcotic use in gynecologic oncology patients. Study Design: An institutional review board–approved retrospective study of all patients who underwent open surgery for gynecologic malignancy was conducted at Thomas Jefferson University Hospital, Philadelphia, PA, between January 2007 and January 2011. Patients were divided into 2 groups: (1) control group (patients who did not have the ON-Q PainBuster System placed intraoperatively) and (2) study group (patients who did have the ON-Q PainBuster System placed intraoperatively). The primary outcome was use of narcotics (in morphine equivalents) during the postoperative period. All statistical analyses were performed using SPSS 17.0; a p-value of <0.05 was considered statistically significant. Results: A total of 200 patients was identified—109 control patients and 91 study patients. Baseline characteristics and intraoperative characteristics did not differ significantly. Study patients used significantly lower amounts of narcotics (total narcotic use, intravenous narcotic use, and oral narcotic use). Study patients reported lower average pain scores, required fewer doses of antiemetics, and had fewer diagnoses of small-bowel obstruction and ileus. Wound toxicity and other postoperative complications did not differ between the two groups. Conclusions: Use of the ON-Q PainBuster System in gynecologic oncology surgery results in decreased postoperative narcotic use, without increasing operative time or increasing wound toxicity. (J GYNECOL SURG 28:202)