64 Pilot study of local anaesthetic infusion pump for analgesia following radical prostatectomy

  The Painbuster TM is a local anaesthetic(LA) infusion pump placed into wounds as a means of reducing postoperative pain. A reservoir is filled with LA under pressure and a controlled constant output of LA is delivered into the wound immediately overlying the muscular closure using epidural‐like catheters. The use of these devices have not previously been reported in the specific setting of open radical prostatectomy. The objective of this pilot study was to assess the impact of the Painbuster TM on postoperative pain scores and narcotic analgesic requirements with a view to providing a basis for power calculations for a randomised study with or without the use of a Painbuster TM . Methods:  Analgesic requirements of 24 consecutive patients undergoing radical prostatectomy were studied. The first 12 (Group A) had Painbuster TM devices in addition to Pain Controlled Analgesia (PCA) devices and the following 12 (Group B) only had PCA devices. As part of standard ward protocol, patients are scored for pain using a 0 to 10 numerical pain score every 1 to 2 h unless asleep. Results:  Conclusions:  Statistical significance was not to be expected given the small numbers in each limb. The Painbuster TM does significantly reduce the maximum pain the patient will experience at any time during the postoperative period in hospital. Use of the Painbuster TM appears to halve narcotic analgesic requirements following radical prostatectomy and allows for some basis upon which appropriate power calculations can be made for Phase 3 studies. 1: for 64Group A Group B P‐valueMean pain score in first 24 h 1.67 2.74 0.06 Mean pain score overall 1.70 2.50 0.10 Masimum pain score reported 3.25 5.91 <0.002 Morphine equivalent requirement 26 51 0.12 Length of stay 3.4 5.1 0.10