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S28-11
(P)
A NON-NARCOTIC BASED POSTOPERATIVE CLINICAL CARE PATHWAY IS A
VIABLE POSTOPERATIVE TREATMENT ALGORITHM FOLLOWING PEDIATRIC
ROBOTIC ASSISTED LAPAROSCOPIC PYELOPLASTY
Zachary LISS, Katherine CORBYONS, Marion SCHULTE, W Robert DEFOOR, Brian VANDERBRINK, Eugene MINEVICH,
Pramod REDDY and Paul NOH
Cincinnati Children's Hospital Medical Center, Pediatric Urology, Cincinnati, USA
PURPOSE
To review our non-narcotic clinical care pathway (NNCP) for postoperative pain control following pediatric robotic
assisted laparoscopic pyeloplasty.
MATERIAL AND METHODS
A retrospective review was performed of all patients who underwent robotic pyeloplasty at a single pediatric
institution. Patient demographics, perioperative details, and outcomes were reviewed. Our non-narcotic clinical care
pathway (NNCP) consists of alternating scheduled intravenous Toradol and intravenous Acetaminophen throughout the
patients postoperative hospital stay. No standing narcotics are ordered and are given only as needed. Statistical
analysis was performed using the Mann-Whitney and Chi Square test where appropriate.
RESULTS
A total of 129 patients (73 male, 56 female) were identified. 75 patients (63%) were placed on the NNCP. Median age
was 83 months (range 3-255) in the NNCP group and 104 months (range 20-279) in the standard pain control (SPC)
group (p<.01). The NNCP was effective in 46 patients (61%) while 29 patients (39%) were given at least 1 dose of
narcotics. Forty-one patients (76%) in the SPC group received narcotics. Median hospital stay was 1 day (range 1-4)
for the NNCP group and 2 days (range 1-7) for the SPC group (p<.01). The surgical success rate was 100% (75/75) for
the NNCP group and 96% for SPC group (52/54), respectively (p=1.00).
CONCLUSIONS
A non-narcotic based postoperative clinical care pathway following pediatric robotic assisted laparoscopic pyeloplasty is a
viable and effective treatment option and is associated with a significantly shorter hospital stay. Patients treated with
this pathway have adequate pain control without the adverse effects of narcotic medications.