Regional anesthesia helps control pain after surgery by providing a focused anesthetic to a specific part of your child's body, without requiring a full general anesthetic. It has been shown to improve outcomes in children who have undergone surgery, including fewer side effects, faster recovery, and less time in the hospital compared with general anesthesia. As noted below, regional anesthetics can also limit or eliminate the need for pain medications such as opioid drugs and other narcotics.
Although some regional anesthetics are given as one-time injections that last eight to 24 hours, some children may be given a catheter-based regional anesthetic. In this approach, a hollow tube called a catheter is left in place when a patient goes home from the hospital and allowed to infuse the affected area with local anesthetics so that pain relief can last as long as needed following surgery. This is also known as home analgesia.
The Home Analgesia Program goal
The goal of our program is to provide in-home comfort to young patients while effectively reducing opioid use. The majority of our patients report being able to manage their post-operative pain without opioids and have high rates of satisfaction with this approach, all while being able to heal from the comfort of their own home. Home analgesia has the benefits of limiting many of the post-surgical problems associated with opioid use, such as nausea, vomiting, constipation, sedation or the feeling of “foggy head,” and respiratory depression or complications. Ultimately, we hope that the option of home analgesia will help decrease opioid dependency while providing the same level of comfort, at home, that our patients have come to expect from Boston Children’s Hospital.
Our approach to catheter-based regional anesthetics (home analgesia)
Boston Children's Home Analgesia Program for Pediatric and Young Adult Patients (BHAPPY) is part of the Boston Children's Department of Anesthesiology, Critical Care and Pain Medicine. We work closely with the hospital's Division of Pain Medicine and all of the surgical specialties to provide our eligible patients with catheter-based regional anesthetics.
Together, we identify young patients for whom catheter-based regional anesthetics may be appropriate. In collaboration with the Boston Children’s surgical, anesthesia, and nursing teams, we create a comprehensive plan for care that begins before surgery and continues for two weeks afterward. During this time, we educate patients and their families about what to expect from the catheter-based regional anesthetic and how to manage it at home. We also conduct a telehealth virtual visit after surgery to help with the recovery, conduct clinical examination, help remove the catheter, and answer any questions. We want to be available to the patients every step of the way.
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