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.