Wound infiltration with plain bupivacaine as compared with bupivacaine fentanyl mixture for postoperative pain relief after abdominal surgery

Chander, Reetika; Liddle, Dootika; Kaur, Baljinder; Varghese, Mary

doi:10.4103/0259-1162.94753

Cited by 5 publications

(1 citation statement)

References 12 publications

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“…Recovery parameters, opioid consumption, associated side effects and patient satisfaction seemed to be in favor of preperitoneal wound catheters compared to epidural analgesia for midline incisions and L-shaped incisions [26,30]. Local anesthetic adjuvants such as dexmedetomidine [120] or fentanyl [121] further increase efficacy without changing the incidence of postoperative nausea and vomiting. Cost-effectiveness analysis suggests that CWI is a promising strategy for managing postoperative pain compared to PCA-IV or epidural analgesia [122].…”

Section: Abdominal Surgerymentioning

confidence: 99%

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: Abdominal Surgerymentioning

confidence: 99%

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

Stamenković

Bezmarević

Bojić

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

The effect of local injection of bupivacaine with and without fentanyl at the operative site in mandibular open reduction on acute pain intensity and opioid requirement: a randomized clinical trial

Nezafati,

Eidy,

Khiavi

et al. 2023

Oral Maxillofac Surg

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Adjuncts to local anesthetic wound infiltration for postoperative analgesia: a systematic review

Bai

Perlas

et al. 2020

Reg Anesth Pain Med

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Local anesthetics (LAs) are commonly infiltrated into surgical wounds for postsurgical analgesia. While many adjuncts to LA agents have been studied, it is unclear which adjuncts are most effective for co-infiltration to improve and prolong analgesia. We performed a systematic review on adjuncts (excluding epinephrine) to local infiltrative anesthesia to determine their analgesic efficacy and opioid-sparing properties. Multiple databases were searched up to December 2019 for randomized controlled trials (RCTs) and two reviewers independently performed title/abstract screening and full-text review. Inclusion criteria were (1) adult surgical patients and (2) adjunct and LA agents infiltration into the surgical wound or subcutaneous tissue for postoperative analgesia. To focus on wound infiltration, studies on intra-articular, peri-tonsillar, or fascial plane infiltration were excluded. The primary outcome was reduction in postoperative opioid requirement. Secondary outcomes were time-to-first analgesic use, postoperative pain score, and any reported adverse effects. We screened 6670 citations, reviewed 126 full-text articles, and included 89 RCTs. Adjuncts included opioids, non-steroidal anti-inflammatory drugs, steroids, alpha-2 agonists, ketamine, magnesium, neosaxitoxin, and methylene blue. Alpha-2 agonists have the most evidence to support their use as adjuncts to LA infiltration. Fentanyl, ketorolac, dexamethasone, magnesium and several other agents show potential as adjuncts but require more evidence. Most studies support the safety of these agents. Our findings suggest benefits of several adjuncts to local infiltrative anesthesia for postoperative analgesia. Further well-powered RCTs are needed to compare various infiltration regimens and agents.Protocol registrationPROSPERO (CRD42018103851) (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=103851)

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Wound infiltration with plain bupivacaine as compared with bupivacaine fentanyl mixture for postoperative pain relief after abdominal surgery

Cited by 5 publications

References 12 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

The effect of local injection of bupivacaine with and without fentanyl at the operative site in mandibular open reduction on acute pain intensity and opioid requirement: a randomized clinical trial

Adjuncts to local anesthetic wound infiltration for postoperative analgesia: a systematic review

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