Forastiere, E., Sofra, M., Giannarelli, D., Fabrizi, L., & Simone, G. (2008). Effectiveness of continuous wound infusion of 0.5% ropivacaine by On-Q pain relief system for postoperative pain management after open nephrectomy. British Journal of Anaesthesia, 101(6), 841–847.doi:10.1093/bja/aen309
To compare, after open nephrectomy, the efficacy of continuous wound site infusion with ropivacaine with that of saline; to examine morphine consumption, side effects, bowel function, and hospital length of stay in two study arms
Patients received continuous surgical wound site infusion of either 0.5% ropivacaine or 0.9% saline. For breakthrough pain, all patients received standard care with PCA morphine and ketorolac.
Prospective randomized, double-blinded, placebo-controlled study
Continuous wound infusion with ropivacaine improved pain relief and accelerated recovery and discharge.
A single surgeon peformed all procedures and placed all catheters. Because of the various locations of nociceptive receptors, this makes generalizing study findings questionable; placement of catheters for local infusion relates to results.
Multimodal pain management that includes continuous wound infusion of anesthetic and systemic opioid can reduce postoperative pain, thereby reducing length of stay and hospitalization costs.