A meta-analysis of the efficacy of wound catheters for post-operative pain management
2011 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 55, no 7, 785-796 p.Article, review/survey (Refereed) Published
Local anesthetics (LA) are injected via catheters placed in surgical wounds for post-operative analgesia. The primary aim of this systematic review was to assess whether LA reduce pain intensity when injected via wound catheters. A literature search was performed from Medline via PubMed, EMBASE and the Cochrane database from 1966 until November 2009. The search strategy included the following key words: pain, postoperative, catheters and local anesthetics. Two co-authors independently read every article that was initially included and extracted data into a pre-defined study record form. A total of 753 studies primarily fit the search criteria and 163 were initially extracted. Of these, 32 studies were included in the meta-analysis. Wound catheters provided no significant analgesia at rest or on activity, except in patients undergoing gynecological and obstetric surgery at 48 h (P = 0.03). The overall morphine consumption was lower (approximate to 13 mg) during 0-24 h (P less than 0.001) in these patients. No significant differences in side effects were found, except for a lower risk of wound breakdown (P = 0.048) and a shorter length of hospital stay (P = 0.04) in patients receiving LA. A statistically significant heterogeneity was seen between the studies in most end-points. LA injected via wound catheters did not reduce pain intensity, except at 48 h in a subgroup of patients undergoing obstetric and gynecological surgery. Rescue analgesic consumption was also lower in this group at 0-24 h. The magnitude of these effects was small and compounded by pronounced heterogeneity.
Place, publisher, year, edition, pages
Blackwell Publishing Ltd , 2011. Vol. 55, no 7, 785-796 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-69776DOI: 10.1111/j.1399-6576.2011.02463.xISI: 000292649500005OAI: oai:DiVA.org:liu-69776DiVA: diva2:433605