Studies show reductions in opioid consumption and length of stay following spine, major foot and ankle, and mastectomy surgeries

Studies show reductions in opioid consumption and length of stay following spine, major foot and ankle, and mastectomy surgeries

Studies show reductions in opioid consumption and length of stay following spine, major foot and ankle, and mastectomy surgeries

Halyard Health, a global medical technology company focused on preventing infection, eliminating pain and speeding recovery, have announced favourable clinical data supporting the use of the ON-Q* Pain Relief System in anterior lumbar interbody fusions (ALIF), complex foot and ankle surgery, and mastectomies. ON-Q* is a non-narcotic elastomeric pump that automatically and continuously delivers a regulated flow of local anaesthetic to a patient’s surgical site or in close proximity to nerves.

Lead author Dr Brian Vaughan, director of Acute Pain at Anaesthesia Associates of Cincinnati and The Christ Hospital, discovered that continuous transversus abdominis plane (TAP) blocks with ON-Q* were shown to be superior to bupivacaine liposome injectable suspension (EXPAREL®). The clinical study of 100 patients compared the efficacy of two techniques for the management of post-operative pain following anterior lumbar interbody fusion (ALIF) – a bilateral TAP block using bupivacaine liposome injection and a continuous TAP block using ON-Q*. Key findings include:

  • Opioid consumption was statistically reduced throughout the hospital stay, with reductions of 46 per cent, 34 per cent and 34 per cent on days 1, 2 and total (respectively) in the ON-Q* group.
  • Patients in the ON-Q* group were able to go home from the hospital one day sooner than patients treated with bupivacaine liposome injection.

“When selecting post-operative pain management solutions, our number-one priority is to offer the best treatment options to our patients,” said Dr Vaughan. “Our study found that ON-Q* enables healthcare professionals to provide better pain management therapy to their patients for a longer period of time, allowing them to take less narcotics and return home from the hospital earlier than those treated with bupivacaine liposome injection.”

Another ON-Q* study authored by Dr Vincent Kasper from United Anaesthesia Services and Dr Steven Raikin from Rothman Institute (both based in the Philadelphia area), describes results from a study comparing postoperative pain control in patients receiving a continuous popliteal infusion with single-injection saphenous nerve block – versus a continuous popliteal infusion with continuous saphenous infusion – while undergoing complex foot and ankle procedures in an outpatient setting. All of the continuous infusions were delivered via ON-Q*. The study found that:

  • Patients in the dual-block (continuous popliteal infusion with continuous saphenous block) group fared better, showing a significant reduction in the consumption of opioid analgesics days 1 and 2 postoperatively (p<0.05).
  • After discharge, patient-reported satisfaction with pain management was significantly higher in the dual-catheter group 8.5 out of 10 vs. 6.4 and 9 vs. 6.9 (p<0.05 POD 1 & 3).
  • Patients in the single-injection group were 2.85 times more likely to require medication to control nausea following discharge.
    • Complex inpatient foot and ankle cases can be managed successfully as outpatients with a dual-catheter continuous block.

Dr Vlad Frenk from Stamford Hospital in Stamford, Connecticut conducted a 139-patient retrospective study that examined the use of ON-Q* to treat post-mastectomy pain. Key findings include:

  • Compared to conventional on-demand opioid-based pain management, continuous paravertebral catheters using ON-Q* reduced opioid consumption by 31 percent.
  • Using ON-Q* in a multimodal fashion with gabapentin reduced length of stay by 0.7 days, as well as a reduction in opioid consumption by 55 percent. A multimodal approach to post-operative analgesia resulted in a significant decrease in inpatient opioid use and decreased length of stay in patients undergoing major breast surgery.

“The results from these studies reinforce the data in more than 170 previously published and presented ON-Q* studies – which demonstrate benefits such as substantial opioid reduction, less pain, reduced costs and improvements in patient satisfaction,” said Roger Massengale, general manager, Acute Pain at Halyard Health.

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