Efficacy and Safety of a Continuous Wound Catheter in Open Abdominal Partial Hepatectomy

Che, Lu; Lü, Xin; Pei, Lijian

doi:10.24920/j1001-9294.2017.024

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…Compared to placebo, both continuous and single-shot ropivacaine WI resulted in lower pain scores, reduced opioid consumption, reduced stress hormones levels, shorter LOS, and faster bowel recovery after open hepatectomy [158][159][160]. CWI showed equivalent efficacy as epidural PCA and opioid intravenous analgesia after open hepatectomy [161,162]. In patients undergoing laparoscopic hepatectomy, WI and ropivacaine infused gelatin sponge placed on the liver cutting surface provided lower pain scores at rest and on movement, reduced opioid consumption, and lower stress hormones levels during 48 h compared with placebo [163].…”

Section: Hepatic Biliary and Pancreatic Surgerymentioning

confidence: 98%

Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Stamenković

Bezmarević

Bojić

et al. 2021

JCM

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Local anesthetic wound infiltration (WI) provides anesthesia for minor surgical procedures and improves postoperative analgesia as part of multimodal analgesia after general or regional anesthesia. Although pre-incisional block is preferable, in practice WI is usually done at the end of surgery. WI performed as a continuous modality reduces analgesics, prolongs the duration of analgesia, and enhances the patient’s mobilization in some cases. WI benefits are documented in open abdominal surgeries (Caesarean section, colorectal surgery, abdominal hysterectomy, herniorrhaphy), laparoscopic cholecystectomy, oncological breast surgeries, laminectomy, hallux valgus surgery, and radical prostatectomy. Surgical site infiltration requires knowledge of anatomy and the pain origin for a procedure, systematic extensive infiltration of local anesthetic in various tissue planes under direct visualization before wound closure or subcutaneously along the incision. Because the incidence of local anesthetic systemic toxicity is 11% after subcutaneous WI, appropriate local anesthetic dosing is crucial. The risk of wound infection is related to the infection incidence after each particular surgery. For WI to fully meet patient and physician expectations, mastery of the technique, patient education, appropriate local anesthetic dosing and management of the surgical wound with “aseptic, non-touch” technique are needed.

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Section: Hepatic Biliary and Pancreatic Surgerymentioning

confidence: 98%

Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Stamenković

Bezmarević

Bojić

et al. 2021

JCM

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Section: Trials Assessing Wimentioning

confidence: 99%

“…The role of WI with local anesthetics to prevent postoperative pain after open liver surgery was evaluated in ten studies, which included a total of 1412 patients: five compared to TEA (2 RCTs, 2 POS, and 1 RO), four to placebo (RCTs), and one to systemic opioids (RCT) [24][25][26][27][28][29][30][48][49][50]. When compared to TEA, the use of WI produced conflicting evidence: two studies proved WI less effective in pain control than TEA while three studies proved no difference; of the three studies that reported data on LOS, one proved WI was associate with shorter LOS compared to TEA and two recorded no differences; no differences in surgical complication after WI or TEA were reported (Table 3) [24,25,[48][49][50]. When compared to the placebo, results showed WI as being more effective in preventing pain and it reduced opioid consumption, but no differences in patient satisfaction were proven; the use of WI was associated with a less systemic release of "stress hormones" (plasma concentration of epinephrine, norepinephrine, and cortisol) than the placebo; there were no differences in the side effects rates between the two treatments (Table 3) [26][27][28][29].…”

Section: Trials Assessing Wimentioning

confidence: 99%

Postoperative Analgesia after Open Liver Surgery: Systematic Review of Clinical Evidence

Dudek

Zawadka

Andruszkiewicz

et al. 2021

JCM

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Background: The existing recommendations for after open liver surgery, published in 2019, contains limited evidence on the use of regional analgesia techniques. The aim of this systematic review is to summarize available clinical evidence, published after September 2013, on systemic or blended postoperative analgesia for the prevention or treatment of postoperative pain after open liver surgery. Methods: The PUBMED and EMBASE registries were used for the literature search to identify suitable studies. Keywords for the literature search were selected, with the authors’ agreement, using the PICOS approach: participants, interventions, comparisons, outcomes, and study design. Results: The literature search led to the retrieval of a total of 800 studies. A total of 36 studies including 25 RCTs, 5 prospective observational, and 7 retrospective observational studies were selected as suitable for this systematic review. Conclusions: The current evidence suggests that, in these patients, optimal postoperative pain management should rely on using a “blended approach” which includes the use of systemic opioids and the infusion of NSAIDs along with regional techniques. This approach warrants the highest efficacy in terms of pain prevention, including the lower incretion of postoperative “stress hormones”, and fewer side effects. Furthermore, concerns about the potential for the increased risk of wound infection related to the use of regional techniques have been ruled out.

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Use of local wound infiltration in open hepatectomy to reduce wound pain: A systematic review and meta‐analysis

Meng

Zhao

Hou

2023

International Wound Journal

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The aim of this study was to assess the effects of local wound infiltration anaesthesia on postoperative wound pain in patients undergoing open liver resection. The Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM) and Wanfang databases were searched. The search period spanned from database creation to December 2022. All relevant studies on local wound infiltration anaesthesia for analgesia after hepatectomy were included. Two investigators independently screened the literature, extracted data and evaluated the quality of each study. Review Manager (RevMan) 5.4 software (Cochrane Collaboration) was used for the meta‐analysis, in which 12 studies with 986 patients were included. The results show that local wound infiltration anaesthesia effectively reduced surgical site wound pain at 4 h (mean difference [MD]: −1.26, 95% confidence intervals [CIs]: −2.15 to −0.37, P = .005), 12 h (MD: −0.84, 95% CIs: −1.26 to −0.42, P < .001), 24 h (MD: −0.57, 95% CIs: −1.01 to −0.14, P = .009) and 48 h (MD: −0.54, 95% CIs: −0.81 to −0.26, P < .001) postoperatively; however, there was no significant difference in analgesia at 72 h postoperatively (MD: −0.10, 95% CIs: −0.80 to 0.59, P = .77). These findings suggest that local wound infiltration anaesthesia administered to patients undergoing open liver resection provides good postoperative wound analgesia at the surgical site.

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Efficacy and Safety of a Continuous Wound Catheter in Open Abdominal Partial Hepatectomy

Cited by 4 publications

References 19 publications

Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Postoperative Analgesia after Open Liver Surgery: Systematic Review of Clinical Evidence

Use of local wound infiltration in open hepatectomy to reduce wound pain: A systematic review and meta‐analysis

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