HCPLive Network

New Wound Infiltration Technique Comparable to Epidural Analgesia in Reducing Postoperative Pain

Analgesia after abdominal surgery can be tricky, as good pain relief is often difficult to tailor to each patient’s needs. Traditional epidural analgesia is an option that causes less nausea and vomiting than opioids, but it isn’t always effective — given that one in four patients is unresponsive — and on rare occasions, patients experience epidural hematoma.

Wound infiltration with local anesthetic delivered continuously by catheter is increasingly popular, as it is generally less likely to cause systemic complications, and it lacks the side effects of opioids.

To determine whether that newer local anesthetic technique is superior to traditional epidural analgesia, researchers at the Royal Infirmary of Edinburgh in the United Kingdom conducted a meta-analysis comparing the two methods. The authors compared each method’s ability to relieve postoperative pain using a numerical rating scale, and they also investigated opiate requirements, nausea and vomiting, urinary retention, local catheter-related complications, and treatment failure for both techniques.


Further Reading
Surgical specialty has limited influence on short-term outcomes after elective spine surgery, with differences noted for transfusions and length of stay, according to a study published online Sept. 1 in Spine.
Watchful waiting may not be suitable for all men with early-stage prostate cancer, especially black patients, according to research published in Urologic Oncology.
Errata, including those that may materially change the interpretation of data, are frequent in medical publications, according to a study published in the August issue of The American Journal of Medicine.
Researchers are testing promising new biologic agents that target different aspects of the inflammatory pathway in rheumatoid arthritis (RA).
On March 21, 2014, the US Food and Drug Administration announced the approval of Celgene Corporation’s Otezla (apremilast), an oral tablet indicated to treat active psoriatic arthritis in adults. Otezla has a single contraindication: known hypersensitivity to the active ingredient or any excipients in Otezla tablets.
Although several medications and dietary factors have been implicated, as causes of gout, much of the risk of developing the condition is controlled through genetics, and the pathophysiology of the disease is incompletely understood.
The choice of an appropriate disease-modifying antirheumatic drug (DMARD) is complicated by the availability of several agents and the lack of comparative effectiveness studies. Until recently, the scientific consensus did not favor any agent over another as the most appropriate initial biologic DMARD for patients with rheumatoid arthritis (RA).
More Reading