Continuous wound infusion of local anaesthetic agents.pdf

to -0.029; P = 0.04, day 3 weighted mean difference: -0.61; 95% CI: 1.01 to -0.20; P = 0.0038). Local an- aesthetic wound infusion was associated with a signifi- cant decrease in total opioid consumption (weighted mean difference: -40.13; 95% CI: -76.74 to -3.53; P = 0.03). There was no significant decrease in length of stay (weighted mean difference: -20.87; 95% CI: -46.96 to 5.21; P = 0.12) or return of bowel function (weighted mean difference: -9.40; 95% CI: -33.98 to 15.17; P = 0.45). CONCLUSION: The results of this systematic re- view and meta-analysis suggest that local anaesthetic wound infusion following laparotomy for major color- ectal surgery is a promising technique but do not pro- vide conclusive evidence of benefit. Further research is required including cost-effectiveness analysis. ? 2008 The WJG Press. All rights reserved. Key words: Colorectal surgery; Laparotomy; Local anaesthesia; Infusion; Wound healing Peer reviewer: Conor P Delaney, MD, MCh, PhD, FRCSI, FACS, Professor of Surgery, Case Western Reserve University, Chief, Division of Colorectal Surgery, Vice-Chairman, Department of Surgery, Director, Institute for Surgery and Innovation, University Hospitals, Case Medical Center, 11100 Euclid Avenue Cleveland, Cleveland 44106-5047, United States Karthikesalingam A, Walsh SR, Markar SR, Sadat U, Tang TY, Malata CM. Continuous wound infusion of local anaes- thetic agents following colorectal surgery: Systematic review and meta-analysis. World J Gastroenterol 2008; 14(34): 5301-5305 Available from: URL: http://www.wjgnet. com/1007-9327/14/5301.asp DOI: /10.3748/ wjg.14.5301 INTRODUCTION Open surgery comprising colonic resection and primary bowel anastomosis accounts for up to a third of elective general surgical admissions[1]. The control of pain following these operations represents a major challenge as highly complex nociceptive pathways are involved[2-4]. Pain control following abdominal laparotomy and bowel anastomosi