Preperitoneal or Subcutaneous Wound Catheters as Alternative for Epidural Analgesia in Abdominal Surgery: A Systematic Review and Meta-analysis

Annals of Surgery
Timothy H MungroopMarc G Besselink

Abstract

To assess whether the location of wound catheters (ie, preperitoneal vs. subcutaneous) impacts outcomes, when compared with alternatives such as epidural analgesia. Continuous wound infiltration is an alternative for epidural analgesia in abdominal surgery but studies have shown conflicting results. This difference could be explained by different efficacy of preperitoneal versus subcutaneous placement of the infiltrative catheters. A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines until April 3, 2017. Primary endpoints were pain scores in rest and when moving at 24 hours postoperatively. Secondary endpoints included postoperative pain scores at 12 and 48 hours, functional recovery, pain treatment-related complications, and patient satisfaction. After screening 2283 studies, 29 randomized controlled trials (RCTs) with 2059 patients were included. Methodological quality of these RCTs ranged from moderate to high. In the one direct comparison (60 patients), preperitoneal catheters led to better pain control than subcutaneous catheters. Superiority of preperitoneal compared with subcutaneous placement was confirmed indirectly in placebo...Continue Reading

Associated Clinical Trials

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Citations

Dec 2, 2019·Best Practice & Research. Clinical Anaesthesiology·Girish P Joshi, Henrik Kehlet
Mar 1, 2021·The British Journal of Surgery·J Ng Cheong ChungA W Phillips
Mar 21, 2021·Best Practice & Research. Clinical Anaesthesiology·Narinder Rawal
May 2, 2021·International Journal of Surgery·Guangnian LiuXiaodong Tian
Nov 26, 2019·Innovative Surgical Sciences·Stephan M Freys, Esther Pogatzki-Zahn
Jun 12, 2021·Annals of Medicine and Surgery·Wiebke FalkShahin Mohseni
Jun 20, 2021·Regional Anesthesia and Pain Medicine·Ki Jinn ChinStephan K W Schwarz
Oct 2, 2021·Regional Anesthesia and Pain Medicine·Andres Rocha-RomeroMario Fajardo Perez

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