Chinese Medical Sciences Journal ›› 2017, Vol. 32 ›› Issue (3): 171-176.doi: 10.24920/J1001-9294.2017.024

• Orginal Article • Previous Articles     Next Articles

Efficacy and Safety of a Continuous Wound Catheter in Open Abdominal Partial Hepatectomy

Che Lu1, Lu Xin2, Pei Li-jian1, *   

  1. 1 Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
    2 Department of Hepatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  • Received:2017-02-05 Online:2017-09-26 Published:2017-09-27
  • Contact: Pei Li-jian

Abstract: Objective

To investigate the efficacy and safety of continuous local anesthetic wound infiltration following open abdominal partial hepatectomy.

Methods

We performed a prospective, non-randomized, concurrent and controlled study. Patients undergoing open abdominal partial hepatectomy, according to their willingness, accepted one of the following managements for the postoperative pain: continuous wound catheter (CWC) infiltration, patient-controlled epidural analgesia (PCEA), patient-controlled intravenous analgesia of morphine (PCIAM), and patient-controlled intravenous analgesia of sufentanil (PCIAS). The primary outcome was postoperative visual analogue scale (VAS) scores at rest and on movement. Secondary outcomes included consumption of rescue medication, side effects, and complications associated with postoperative pain management.

Results

From August 2013 to December 2013, 80 patients were allocated to receive CWC (n=10), PCEA (n=22), PCIAM (n=29), or PCIAS (n=19). After adjusting for age, sex, body mass index, percentage of resected liver, operation time, and Amsterdam Preoperative Anxiety and Information Scale, there was no significant difference in the VAS scores at rest or on movement between Group CWC and the other groups, namely PCEA, PCIAM, and PCIAS, at 4, 12, 48, and 72 hours postoperatively (all P>0.05). The need for rescue medication was not significantly different between Group CWC and the other three groups at 48 and 72 hours postoperatively (all P>0.05). There was no significant difference in the incidence of postoperative nausea and vomiting or anal exsufflation time between group CWC and the other three groups (all P>0.05). No severe adverse effects associated with continuous wound infiltration were observed during the study period.

Conclusions

CWC has a comparable analgesic effect compared with traditional analgesia methods at most time points postoperatively. CWC is a safe alternative for the postoperative analgesic management of open liver surgery.

Key words: continuous wound catheter, postoperative pain, partial hepatectomy

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