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Summary Background Ambulatory continuous peripheral nerve blocks (CPNBs) are feasible for pediatric patients. We sought to evaluate the efficacy of CPNBs 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 CPNBs and On-Q pumps, and any complications and side effects related to CPNBs. Results Four hundred and three patients (403; aged 5–22) were discharged home with 410 CPNBs (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 CPNBs. Conclusion Our patients and their caregivers were very satisfied with ambulatory CPNBs. When combined with oral analgesics, CPNBs provided effective home postoperative analgesia.

Study Objective: It is to compare continuous thoracic paravertebral blockade and thoracic epidural catheters for postoperative pain after VATS and chemical pleurodesis in children. Design: Case series, retrospective chart review. Setting: Children’s Hospital of University of Pittsburgh Medical Center. Patients: We studied seventeen (17) pediatric patients who underwent VATS with chemical pleurodesis. Interventions: Fourteen children (14) had continuous thoracic paravertebral blockade and three children (3) had thoracic epidural catheters. Measurements and main results: Postoperative pain scores and consumption of analgesics were compared during the first 48 hours after surgery. Total length of hospital stay and complications secondary to analgesics and regional analgesia were analyzed and compared. Median pain scores were similar with P-values ranging from P = 0.13-0.76. Opioid consumption was not significantly different, with P-values for opioid morphine equivalency ranging from P= 0.13-0.96. Length of stay was significantly shorter for thoracic paravertebral group (3.86, SD±0.77) than for thoracic epidural group (5.00, SD±1.00) (P= 0.04). The rate of complications was low; frequency of nausea /emesis (P= 0.16) and itching (P= 0.60) was similar between groups.