Postoperative pain pumps have become “smarter” over the years, enabling providers to better ensure patients get the right dosages of anesthetic medicine at the right times — and even allowing individuals in recovery to give themselves an extra boost when they really need it. Some newer pumps even allow providers to monitor their patients’ usage of analgesics in real time or analyze collected data for improving how pain is managed.
The devices allow anesthesia providers to extend high-quality pain control beyond the OR while reducing use of opioids, according to Jeff Gadsden, MD, an anesthesiologist and division chief for orthopedics, plastics and regional anesthesiology at Duke University Medical Center in Durham, N.C. “The local anesthetics we use might be able to provide 24 hours of relief at best,” he says. “Placing a continuous catheter and hooking it up to a reservoir of local anesthetic that pumps to the nerve site over the course of several days works well.”
Many surgical facilities use older elastomeric pain pumps. “These are rubbery balls filled with liquid local anesthetic to the point where they are very taut, and the elastic recoil of the ball pushes local anesthetic through the tubing to the patient,” says Dr. Gadsden. The problem with elastomeric pumps is accuracy. “They notoriously have a plus-minus on their ranges, so you might be underdosing or in some cases overdosing the patient,” he adds.
That has led to interest in more precise technology for delivering local anesthetics — usually meds with good safety profiles such as ropivacaine or bupivacaine. Many providers also would like to empower patients to administer additional small doses of medication or even reduce the amount of medication if they feel too numb. These issues have led to increased adoption of electronic pumps.