Efficacy of Continuous Wound Catheters Delivering Local Anesthetic for Postoperative Analgesia: A Quantitative and Qualitative Systematic Review of Randomized Controlled Trials

Abstract

E A a n ffective postoperative analgesia is important from the atient’s perspective and can also improve clinical outomes. Recent surveys report only modest success in roviding suitable analgesia, as 30% to 86% of surgical atients report moderate to severe pain after a surgical rocedure. Although “advanced” analgesic techniques, uch as epidural analgesia or perineural catheters, can rovide superior analgesia, many of these analgesic moalities are labor-intensive and expensive. A promising odality that might help improve postoperative analgeia is the relatively simple technique in which the sureon directly places a catheter to infuse local anesthetic nto wounds at the end of the procedure. This modality an be widely used, is technically efficient, offers the otential to provide complete analgesia or to substanially reduce the need for opioids and their related side ffects, can be used for several days, and can now, with he introduction of new portable pumps, be used on an mbulatory basis. Although there are multiple reports nd small randomized controlled trials (RCTs) examinng use of continuous wound catheters in multiple surical procedures, there have been conflicting reports of he overall efficacy, and no single, large RCT has defintively assessed the risk benefit of this modality. We conucted this systematic review of randomized trials to etermine the efficacy of this modality.