Is local anesthetic wound infusion following laparotomy effective for colorectal surgery?
Although suboptimal postoperative pain control is associated with cardiovascular, respiratory and gastrointestinal complications, many multimodal regimens for analgesia following major colorectal laparotomy provide inadequate pain relief. Continuous wound infusions of local anaesthetics are a promising development as an adjunct to existing multimodal postoperative analgesic regimens. There is a need for a focused, quantitative review of the evidence specific to colorectal laparotomy. A research article to be published on September 14, 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Mr Malata at Addenbrooke's Hospital demonstrates potential benefit of continuous wound infusions of local anaesthetics in terms of reduction in opioid consumption following laparotomy for major colorectal surgery.
Their review highlights the need for future research on this topic and identifies that such future research should address the inaccuracies introduced by the methodological heterogeneity identified in available trials, and provides a cost-effectiveness analysis of the use of continuous wound infusions in colorectal surgery.