Bupivacaine Wound Instillation via an Electronic Patient-Controlled Analgesia Device and a Double-Catheter System Does Not Decrease Postoperative Pain or Opioid Requirements After Major Abdominal Surgery

Fredman, Brian; Zohar, Edna; Tarabykin, Alex; Shapiro, Arie; Mayo, Ami; Klein, Ehud; Jedeikin, Robert

doi:10.1097/00000539-200101000-00036

Cited by 97 publications

(60 citation statements)

References 7 publications

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“…Several studies have reported on use of pre-emptive local anaesthetics (local anaesthetic given during the operation to prevent or reduce pain afterwards) to relieve postoperative pain, with results ranging from being beneficial 5,6 to conferring no benefit. 7,8 The local anaesthetic may be administered by pre-or postincisional abdominal nerve block (local anaesthetic injected to block the nerves before cutting the skin at the beginning of the operation, or after closing the skin at the end 9 ) or pre-or post-incisional abdominal wound infiltration. 5,10 It may also be administered by continuous wound irrigation.…”

mentioning

confidence: 99%

Caesarean section wound infiltration with local anaesthesia for postoperative pain relief: any benefit?th lo

Bamigboye

Hofmeyr²

2010

S Afr Med J

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mentioning

confidence: 99%

Caesarean section wound infiltration with local anaesthesia for postoperative pain relief: any benefit?th lo

Bamigboye

Hofmeyr²

2010

S Afr Med J

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“…After screening, 5 randomised controlled trials were identified [22][23][24][25][26] . The five trials included 542 laparotomy wounds, of which 259 were randomised to infusion of local anaesthetic agents.…”

Section: Resultsmentioning

confidence: 99%

“…Opioid consumption: Four of the five trials reported total opioid consumption with or without local anaesthetic wound infusions [22][23][24][25] ( Figure 1A). Local anaesthetic wound infusion was associated with a significant decrease in total opioid consumption (weighted mean difference: -40.13; 95% CI: -76.74 to -3.53; P = 0.03).…”

Section: Outcome Measuresmentioning

confidence: 99%

Continuous wound infusion of local anaesthetic agents following colorectal surgery: Systematic review and metaanalysis

Karthikesalingam¹,

Walsh²,

Markar³

et al. 2008

WJG

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to -0.029; P = 0.04, day 3 weighted mean difference: -0.61; 95% CI: 1.01 to -0.20; P = 0.0038). Local anaesthetic wound infusion was associated with a significant decrease in total opioid consumption (weighted mean difference: -40.13; 95% CI: -76.74 to -3.53; P = 0.03). There was no significant decrease in length of stay (weighted mean difference: -20.87; 95% CI: -46.96 to 5.21; P = 0.12) or return of bowel function (weighted mean difference: -9.40; 95% CI: -33.98 to 15.17; P = 0.45). CONCLUSION:The results of this systematic review and meta-analysis suggest that local anaesthetic wound infusion following laparotomy for major colorectal surgery is a promising technique but do not provide conclusive evidence of benefit. Further research is required including cost-effectiveness analysis. INTRODUCTIONOpen surgery comprising colonic resection and primary bowel anastomosis accounts for up to a third of elective general surgical admissions [1] . The control of pain following these operations represents a major challenge as highly complex nociceptive pathways are involved [2][3][4] . Pain control following abdominal laparotomy and bowel anastomosis is therefore not amenable to Abstract AIM: To provide a specific review and meta-analysis of the available evidence for continuous wound infusion of local anaesthetic agents following midline laparotomy for major colorectal surgery. METHODS: Medline, Embase, trial registries, conference proceedings and article reference lists were searched to identify randomised, controlled trials of continuous wound infusion of local anaesthetic agents following colorectal surgery. The primary outcomes were opioid consumption, pain visual analogue scores (VASs), return to bowel function and length of hospital stay. Weighted mean difference were calculated for continuous outcomes. RESULTS: Five trials containing 542 laparotomy wounds were eligible for inclusion. There was a significant decrease in post-operative pain VAS at rest on day 3 (weighted mean difference: -0.43; 95% CI: -0.81 to -0.04; P = 0.03) but not on post-operative day 1 and 2. Local anaesthetic infusion was associated with a significant reduction in pain VAS on movement on all three post-operative days (day 1 weighted mean difference: -1.14; 95% CI: -2.24 to -0.041; P = 0.04, day 2 weighted mean difference: -0.97, 95% CI: -1.91

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“…3,4 The local anaesthetic may be administered by pre or postincisional abdominal nerve block (local anaesthetic injected to block the nerves before cutting the skin at the beginning of the operation, or after closing the skin at the end) 5 or pre-or postincisional abdominal wound infiltration. 1,6 Local anaesthetics eventually get absorbed systemically and secreted in breast milk, but their effects on breastfed babies have not yet been documented.…”

mentioning

confidence: 99%

Ropivacaine Hydrochloride 0.2% Local Infiltration and Intraperitoneal Instillation for Postoperative Pain Relief in Caesarean Section Under Spinal Anaesthesia: A Randomised Clinical Study

Gautam¹,

Muzalda²,

Tandon³

2016

jemds

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Bupivacaine Wound Instillation via an Electronic Patient-Controlled Analgesia Device and a Double-Catheter System Does Not Decrease Postoperative Pain or Opioid Requirements After Major Abdominal Surgery

Abstract: After major abdominal surgery performed through a 20-cm incision, repeated 0.25% bupivacaine wound instillation via an electronic patient-controlled analgesia device and a double-catheter system does not decrease postoperative pain or opioid requirements.

Cited by 97 publications

References 7 publications

Caesarean section wound infiltration with local anaesthesia for postoperative pain relief: any benefit?th lo

Caesarean section wound infiltration with local anaesthesia for postoperative pain relief: any benefit?th lo

Continuous wound infusion of local anaesthetic agents following colorectal surgery: Systematic review and metaanalysis

Ropivacaine Hydrochloride 0.2% Local Infiltration and Intraperitoneal Instillation for Postoperative Pain Relief in Caesarean Section Under Spinal Anaesthesia: A Randomised Clinical Study

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