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Ropivacaine forContinuous WoundInfusion forPostoperative PainManagement: ASystematic Review andMeta-Analysis ofRandomized ControlledTrials Shane RainesCecilia HedlundMalin Franzon2014 год

Ropivacaine for Continuous Wound Infusion for Postoperative Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
review

Страница публикацииПубликация в OpenAlex
Аннотация: <b><i>Background:</i></b> The use of continuous wound infusion (CWI) of local anaesthetics has been suggested as a safe and effective alternative technique to epidural anaesthesia/analgesia that allows surgeons to provide postoperative pain relief while reducing opioid consumption and associated adverse events. A previous meta-analysis by Liu et al. [Am Coll Surg 2006;203:914-932] reported results mainly from studies of bupivacaine. Subsequently, several new randomized controlled trials (RCTs) of ropivacaine have been published. This systematic review and quantitative meta-analysis evaluates the efficacy of ropivacaine for CWI. <b><i>Methods:</i></b> Systematic literature searches (EMBASE, MEDLINE) were performed to retrieve studies which met the following criteria: double-blind RCT of ropivacaine versus either placebo or an active comparator; use of ropivacaine solution without added active agents, and prohibition of other routine analgesics during the study period except rescue patient-controlled analgesia. For each included study, standardized effect sizes for ropivacaine versus placebo were calculated for opioid rescue use, pain score at rest, and pain score at mobilization. Meta-analyses were conducted for each endpoint. <b><i>Results:</i></b> Fourteen RCTs comparing ropivacaine (n = 376) versus placebo (n = 380) were identified. Effect size estimates revealed significantly less opioid rescue use for ropivacaine patients (-1.3; 95% CI -1.5 to -1.1) and significantly less pain for ropivacaine patients both at rest (-1.1; 95% CI -1.3 to -0.9) and on mobilization (-1.5; 95% CI -1.7 to -1.3). The weighted mean reduction in opioid rescue use was 22.4 mg. <b><i>Conclusion:</i></b> This systematic review and meta-analysis presents substantial evidence that ropivacaine provides clinically meaningful reductions in opioid use and pain outcomes. Ropivacaine CWI is effective for postoperative pain management in a wide range of surgical procedures.
Год издания: 2014
Авторы: Shane Raines, Cecilia Hedlund, Malin Franzon, Stefan Lillieborg, Glen Kelleher, Kjell Ahlén
Издательство: Karger Publishers
Источник: European Surgical Research
Ключевые слова: Anesthesia and Pain Management, Pediatric Pain Management Techniques, Nausea and vomiting management
Другие ссылки: European Surgical Research (HTML)
PubMed (HTML)