The effectiveness of ambulatory continuous peripheral nerve blocks for postoperative pain management in children and adolescents

Summary Background Ambulatory continuous peripheral nerve blocks ( CPNB s) are feasible for pediatric patients. We sought to evaluate the efficacy of CPNB s in a pediatric population. Methods This retrospective report of 33‐month prospectively collected data investigates patient, parent, and nurse pain control satisfaction score ( PCSS ), the incidence and severity of pain, daily analgesic consumption following discharge home with various CPNB s and On‐Q pumps, and any complications and side effects related to CPNB s. Results Four hundred and three patients (403; aged 5–22) were discharged home with 410 CPNB s (brachial and lumbar plexus, femoral, sciatic, and paravertebral); 76.7% on the day of surgery. The median/interquartile range ( IQR ) ropivacaine continuous infusion via On‐Q pump was 0.24 (0.20–0.30) mg·kg −1 ·hr −1 , and the median/ IQR duration was 72 (48–72) h. The median/ IQR home PCSS was 10 (9–10). Median Postoperative Ambulatory Care Unit ( PACU )/ IQR pain control satisfaction scores were 10 (8–10) for the patient, 10 (9–10) for the parent, and 10 (9–10) for the nurse. Thirty‐three (10.0%) patients did not report any pain at home, and median maximum home/ IQR pain score was 4 (2–6). In the PACU , 126 (31.3%) patients did not report any pain and median/ IQR pain score was 1 (0–3). No opioids were administered at home for 12 (4.3%) patients and in the PACU for 150 (37.4%). Sixty‐three (14.4%) complications and side effects for 58 patients were reported. We report 93.1% ambulatory efficacy of CPNB s. Conclusion Our patients and their caregivers were very satisfied with ambulatory CPNB s. When combined with oral analgesics, CPNB s provided effective home postoperative analgesia.