"CPNB has never been done routinely in pediatrics," adds Dr. Ganesh. "I don't know of any other institution that regularly sends children home with catheters. They may be starting to do it now, after we have shown in studies that it works. One of the main reasons for the successful launch of this program was the acceptance and interest generated by our orthopaedic surgeons and pain nurse practitioners who helped train the post anesthesia care unit and educate parents, without whom this program would not have taken off."
The authors caution that a hospital must provide appropriate patient and family education concerning in-home use as well as frequent follow-up, to prevent and correct complications from the procedure. The complications may include infections, difficulty in removing the catheter, inadequate analgesia, leakage from the insertion and injury resulting from a fall or trauma to the extremity. The overall failure rate was 15 percent.
Also, because of the limited number of patients examined in this study, the incidence of rare serious adverse events could have been underestimated. Therefore, additional studies are needed, the authors concluded.
Dr. Ganesh's co-authors from The Children's Hospital are John B. Rose, M.D.; Lawrence Wells, M.D.; Theodore Ganley, M.D.; Harshad Gurnaney, M.D.; Lynne G. Maxwell, M.D .; Theresa DiMaggio, M.S.N.; Karen Milovcich, M.S.N.; Maureen Scollon, M.S.N.; Jeffrey M. Feldman, M.D.; and Giovanni Cucchiaro, M.D.
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|SOURCE The Children's Hospital of Philadelphia|
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