A comparison of the hourly output between the Ambu^® Smart‐Infuser^™ Pain Pump and the On‐Q Pump^® with Select‐A‐Flow^™ Variable Rate Controller with standard and overfill volumes

Abstract

This investigation demonstrates that no change in the hourly output occurs with overfilling of these home infusion devices. However, as noted previously, the hourly output from the On-Q device is significantly higher than the set rate during the initial 8 h of infusion which could have potential clinical implications.

Advances in regional anesthesia for ambulatory surgery

“…Elastomeric pumps infuse at higher rates at the beginning of the infusion when maximally filled, drop below the intended rate, and then infuse at a higher rate than programmed at the termination of the volume of LA. 47 In addition, the elevation of the pump reservoir and back pressure from the infusion may affect the accuracy of the infusions in elastomeric pumps. 48,49 Technologically, elastomeric pumps do not have alarms for kinking or malfunctioning, cannot detect air in the infusion, nor accurately identify volume remaining in the pump.…”

“…48,49 Technologically, elastomeric pumps do not have alarms for kinking or malfunctioning, cannot detect air in the infusion, nor accurately identify volume remaining in the pump. 47 While limited in some functions, there is also a potential benefit to their simplicity.…”

Efficacy of a local anesthetic gel infusion kit for pain relief after minimally invasive colorectal surgery: an open-label, randomized clinical trial

“…In patients undergoing laparoscopic colorectal surgery, On-Q has been shown to control acute postoperative pain and reduce the associated usage of opioid analgesics 3 . Although there are benefits, CWI is associated with certain complications as the process involves the initial insertion of a catheter between the peritoneum and the fascia, followed by removal of the catheter several days after surgery, which can lead to drug leaking out of the catheter and malfunctioning of the On-Q pump 7 – 10 . Therefore, there is a need for pain control products that are easier to apply as the use of such products could reduce the discomfort and inconvenience of patients after surgery.…”

Elastomeric pump malfunction resulting in over-infusion of local anesthetic

“…3–5 However, it has been suggested that these pumps may deliver inconsistent volume which could lead to inadequate analgesia or unintended side effects. 6,7 Such disadvantages can be caused by a multitude of factors such as temperature changes, viscosity of infused fluid, and even the height of the elastomeric pump relative to the catheter site. 8,9 Iliev et al 6 found that the On-Q pump (I-Flow Corporation, Halyard Health, Irvine, CA, USA) delivered 22%–65% higher volume than the set rate during the initial 8 h of the infusion, followed by volume infusion within 20% of the intended delivery rate thereafter.…”

“…6,7 Such disadvantages can be caused by a multitude of factors such as temperature changes, viscosity of infused fluid, and even the height of the elastomeric pump relative to the catheter site. 8,9 Iliev et al 6 found that the On-Q pump (I-Flow Corporation, Halyard Health, Irvine, CA, USA) delivered 22%–65% higher volume than the set rate during the initial 8 h of the infusion, followed by volume infusion within 20% of the intended delivery rate thereafter. According to another study, the ACTion pump (Ambu USA, Columbia, MD, USA) was the only studied pump that tested within the acceptable flow rate ranges.…”