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A meta-analysis of the efficacy of wound catheters for post-operative pain management
Linköping University, Department of Medical and Health Sciences, Anesthesiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Anaesthesiology and Surgery UHL.
Orebro University Hospital.
University Orebro.
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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
Abstract [en]

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.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-69776DOI: 10.1111/j.1399-6576.2011.02463.xISI: 000292649500005OAI: diva2:433605
Available from: 2011-08-10 Created: 2011-08-08 Last updated: 2012-03-19

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Gupta, Anil
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AnesthesiologyFaculty of Health SciencesDepartment of Anaesthesiology and Surgery UHL
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