Pain Management Practice Patterns for Common Pediatric Urology Procedures

ObjectiveTo characterize practice patterns among members of the Society for Pediatric Urology.MethodsA survey instrument assessing pain management was e-mailed to all members of the Society for Pediatric Urology. Five hundred fifteen invitations were sent, 134 were included, for a 26% response rate. Pain management strategies were assessed for 7 case scenarios. Surveys were included if the responder answered a minimum of 2 case scenarios. Question Pro survey engine was used to process the survey.ResultsLocal/regional block was the most frequent intraoperative anesthesia (54%-90%). Epidural/caudal use varied from 19% to 42%. For postop opioids, a dichotomy exists between those without age restriction and those who wait until the patient is 6 months old. Sixty three percent responded that ketorolac was prescribed only if the patient had normal renal function, 20% after confirmation of adequate urine output for bilateral procedures, 3% when postoperative creatinine was normal, and 14% did not use ketorolac at all. In regards to age limitations, most did not indicate a limit (53%), whereas a large number required the child to be older than 6 months (26%). Regarding local blocks, most urologists perform the block themselves (61%) for simple/complex penile surgery or inguinal surgery. Of this group, only 33% actually bill for the administration of the block. After a caudal block, a minority (26%) of respondents require the patient to void before discharge for ambulatory procedures.ConclusionThere is no clear consensus in pain management for common pediatric urologic procedures. These disparities should be the aim of future studies.