Study Confirms Breakthrough Treatment Can Reduce Opioid Use after Surgery

A new study by the University of Pittsburgh Medical Center which followed patients for five days after common outpatient orthopedic surgery found they reported high satisfaction with their pain management when provided with a peripheral nerve catheter connected to an infusion pump that was programmed with an intermittent bolus function. In a second key endpoint of the study, the evidence suggested that treatments with a duration longer than three days could be more effective in reducing pain and opioid use, both of which peaked after the catheter was removed on the third postoperative day.

Patients were "highly satisfied with their pain management," reporting a mean satisfaction score of 9.4 out of 10, according to the study. This outcome adds to the emerging body of literature suggesting that catheters using electronic infusion pumps with a Programmed Intermittent Bolus function (PIB) in addition to the standard Patient-Controlled Analgesia (PCA) improve the efficacy of pain management. With the Patient-Controlled Anesthesia function, predominant in the field of pain management, patients have the option to choose when to receive an extra dose of medication with the push of a button to relieve breakthrough pain rather than turning to prescription painkillers to supplement their pain management plan. Now, new cost-effective pain pumps equipped with Intermittent Bolus functionality go one step further by administering local anesthetic doses automatically over scheduled intervals throughout the treatment. The Intermittent Bolus function can replace slow continuous drip infusions and has been shown to optimize pain management outcomes while avoiding side effects commonly associated with opioids.

The study also yielded new evidence in favor of extending the duration of the local anesthetic infusion from three days to as many as five days after the operation. The data showed that ending the infusion as early as the third postoperative day (POD) resulted in high levels of refractory pain. On POD 4, patients reported an increase in pain both at rest as well as with activity resulting in increased opioid consumption, suggesting that a longer duration of local anesthetic infusion could have prevented this unanticipated outcome. These findings call for future studies to evaluate the effect of extending the duration of local anesthetic infusions to as many as five days to reduce or eliminate the need for opioid use in the postoperative recovery period.

Patients at the University of Pittsburg Medical Center who had undergone upper and lower extremity surgery were provided with a Nimbus II PainPRO, a non-narcotic ambulatory infusion pump distributed by InfuTronix Solutions. As the opioid crisis continues, hospitals are increasingly turning to cost-effective, accurate pumps such as the Nimbus, which are capable of displacing and even eliminating the need for opioids in postoperative care. While evidence mounts on the effectiveness of the Nimbus's Intermittent Bolus functionality and accurate handling of longer-duration treatments, further data is needed on later stages in the patient's postoperative experience, past the point when the infusion is completed and the catheter removed. The lack of information on this period is beginning to be addressed by new app-based automatic tracking systems.

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