A Clinical Evaluation of the Gemstar® and the Ambit® Pumps for Patient-Controlled Epidural Analgesia

Background: Patient-controlled analgesia is used for both labor and postoperative analgesia.Objectives: This study aimed to assess user satisfaction and functionality of two ambulatory,electronic patient controlled analgesia devices, the GemStar pump Hospira Inc., Illinois, USA)and the ambIT Ambulatory Infusion Therapy pump (Sorenson Medical Products, Utah, USA).Patients and Methods: It was a randomized clinical trial of laboring women and postoperativegynecology patients receiving patient-controlled epidural analgesia. Patients were randomizedto use one of the pumps and both anesthesiologists and patients completed questionnairesabout aspects of pump function, and rated their satisfaction with the equipment.Midwives and high-dependency unit nurses also evaluated the pumps in each clinical setting.Results: Forty patients, 20 laboring women and 20 postoperative patients were randomizedand completed the study. The pumps were compared by nine anesthesiologists. Patient andstaff satisfaction with both devices was high. Patient satisfaction did not significantly differbetween groups (median 10 [8, 10] for the GemStar and 10 [9, 10] for the ambIT, P = 0.525]. Themedian staff satisfaction score was 8 [6, 8] for the GemStar and 7 [5, 8] for the ambIT (P = 0.154).Both patient cohorts rated each pump highly for most aspects of clinical function. Staff ratedthe ambIT pump more favourably with respect to portability and storage at the bedsidewhilst the GemStar had better assessments with respect to its consumables and interactionsinvolving the electronic interface.Conclusions: Both devices were well-rated by patients and staff, with no significant differencebetween them for overall satisfaction, and only minor differences with respect to theirrespective strengths and weaknesses.