On-Q Pump vs Epidural for Postoperative Pain Control in Children

January 20, 2022 updated by: Bindi Naik-Mathuria, Baylor College of Medicine

On-Q Pump vs Epidural for Postoperative Pain Control in Children Undergoing Oncologic Surgery

Open abdominal and pelvic surgery or thoracotomy (open chest surgery) is frequently performed for tumor excision in children. Post-operative pain management regimens are often at the discretions of the attending surgeon and may include opiods, patient administered analgesia (PCA), epidural catheters, subcutaneous analgesia catheters or NSAIDS to control incisional pain. Currently, both epidural or subcutaneous analgesia catheters (On-Q pumps) are commonly used for children undergoing these operations, at the discretion of the surgeon. There are no studies comparing these regimens in children. The purpose of this study is to compare postoperative pain control of the two strategies.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

The study design is a randomized, controlled trial to compare the effectiveness of on-q pump subcutaneous incisional analgesia to epidural analgesia for postoperative pain relief in children undergoing open abdominal, thoracic, or pelvic operations for oncologic purposes. The patient and treating team will be blinded to the pain control device. The primary outcome is additional narcotic usage for 3 post-operative days, and secondary outcomes are pain scores for 3 post-operative days, post-surgical day of ambulation, time to regular diet, infectious complications (UTI, wound infection or pneumonia), and hospital length of stay. Outcomes from both groups will be directly compared in order to determine whether one strategy provides more effective pain control with less complications than the other, or whether they are equivalent.

Study Type

Interventional

Enrollment (Actual)

32

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Texas
      • Houston, Texas, United States, 77005
        • Texas Children's Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

3 years to 14 years (Child, Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Weight > 5kg
  • Age younger than 19 years of age
  • Planned abdominal, pelvic or thoracic operation for an oncologic indication

Exclusion Criteria:

  • Patients deemed inappropriate for placement of epidural by anesthesiologist
  • Minimally invasive operation
  • Biopsy through limited incision
  • History of chronic narcotic or opioid use
  • History of drug abuse

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: On-Q Group
Patients in this group will have an On-Q pump placed at the end of the operation
Type of pain control device used
Active Comparator: Epidural Group
Patients in this group will have an epidural catheter placed at the end of the operation
Type of pain control device used

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Additional narcotic use
Time Frame: 3 days
Mg of additional narcotics used for 3 post-operative days
3 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain scores
Time Frame: 3 days
Visual analog scores provided by patients every 4 hours will be collected for 3 post-operative days
3 days
Days to ambulation
Time Frame: 0-5 days
The first post-operative day that patients are ambulating outside the room will be noted
0-5 days
Days to initiation of regular diet
Time Frame: 0-5 days
The first post-operative day of initiation of a regular diet will be noted
0-5 days
Development of postoperative infection
Time Frame: 0-5 days
Infections (such as urinary tract infection, wound infection, or epidural site infection) will be noted
0-5 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Bindi Naik-Mathuria, MD, Baylor College of Medicine

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 1, 2018

Primary Completion (Actual)

June 1, 2021

Study Completion (Actual)

December 1, 2021

Study Registration Dates

First Submitted

March 30, 2018

First Submitted That Met QC Criteria

April 5, 2018

First Posted (Actual)

April 12, 2018

Study Record Updates

Last Update Posted (Actual)

February 3, 2022

Last Update Submitted That Met QC Criteria

January 20, 2022

Last Verified

January 1, 2022

More Information

Terms related to this study

Other Study ID Numbers

  • H-42606

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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