Pectus excavatum: Benefit of randomization

Minimally invasive bar repair for pectus patients produces substantial pain which dictates the post-operative hospital course. We have data from 2 randomized trials comparing epidural catheter placement to patient controlled analgesia. The purpose of this study was to compare the outcomes of patients who were enrolled in the trials to those that did not participate in the trials.

A retrospective chart review was performed on patients not enrolled in the trials to compare to the prospective datasets from October 2006 to June 2014. Perioperative outcomes were examined.

There were 135 patients in a study protocol (IS) and 195 patients that were not enrolled in a study (OS). Comparing the entire IS and OS groups, length of stay was less in the IS group, as was time to regular diet. Average pain scores, operative time and complication rates were not significantly different between the groups. Of the IS patients a significantly lower number of patients had epidural failure, requiring substitution of a PCA for pain control.

There are benefits derived from participating in our randomized trials comparing epidural to patient controlled analgesia after bar placement for pectus excavatum regardless of which arm is utilized.