Haifang Li1, Rui Chen2, Zaiqi Yang3, Cuifang Nie4, Shengqiang Yang5. 1. Anesthesiology Department, the Third People's Hospital of Qingdao, Qingdao City, ShanDong Province 266041, China. 2. Anesthesiology Department, the Second People's Hospital of Xintai, Xintai City, ShanDong Province 271219, China. 3. Anesthesiology Department, Taian City Central Hospital, Tai'an City, ShanDong Province 271000, China. 4. Infectious Diseases Department, Taian City Central Hospital, Tai'an City, ShanDong Province 271000, China. 5. Anesthesiology Department, Taian City Central Hospital, Tai'an City, ShanDong Province 271000, China. Electronic address: yaq8080808@hotmail.com.
Abstract
PURPOSE: The study aimed to compare the effect of epidural anesthesia (EA) and continuous wound infiltration (CWI) on surgical patients. METHODS: The literature retrieval was conducted in relevant databases from their inception to June 2018 with the predefined searching strategy and selection criteria. Then, the Cochrane Collaboration's tool was used to assess the quality of included studies. In addition, odds ratio (OR) and standardized mean difference (SMD) with its corresponding 95% confidence interval (CI) were used as a measure of effect size for evaluating outcomes indicators. RESULTS: Totally, sixteen RCTs were included. The incidence of hypotension in EA group was significantly higher than CWI group (OR = 3.7398; 95% CI: 1.0632 to 13.1555). In addition, EA provided better pain relief than CWI on rest at 72 h (SMD = -0.6037; 95% CI: -1.0767 to -0.1308) after surgery. Additionally, there were no significant differences in pain score on rest and mobilization at 2 h, 12 h, 24 h and 48 h. Moreover, the subgroup analysis showed that pain scores in EA group was significantly reduced at 2 h on rest and 12 h on mobilization than CWI group after liver resection surgery, as well as at 72 h on rest after colorectal surgery. CONCLUSION: CWI is superior to EA with a lower incidence of complications for use in surgery, and EA may provide better pain control than CWI on pain relief after surgery.
PURPOSE: The study aimed to compare the effect of epidural anesthesia (EA) and continuous wound infiltration (CWI) on surgical patients. METHODS: The literature retrieval was conducted in relevant databases from their inception to June 2018 with the predefined searching strategy and selection criteria. Then, the Cochrane Collaboration's tool was used to assess the quality of included studies. In addition, odds ratio (OR) and standardized mean difference (SMD) with its corresponding 95% confidence interval (CI) were used as a measure of effect size for evaluating outcomes indicators. RESULTS: Totally, sixteen RCTs were included. The incidence of hypotension in EA group was significantly higher than CWI group (OR = 3.7398; 95% CI: 1.0632 to 13.1555). In addition, EA provided better pain relief than CWI on rest at 72 h (SMD = -0.6037; 95% CI: -1.0767 to -0.1308) after surgery. Additionally, there were no significant differences in pain score on rest and mobilization at 2 h, 12 h, 24 h and 48 h. Moreover, the subgroup analysis showed that pain scores in EA group was significantly reduced at 2 h on rest and 12 h on mobilization than CWI group after liver resection surgery, as well as at 72 h on rest after colorectal surgery. CONCLUSION:CWI is superior to EA with a lower incidence of complications for use in surgery, and EA may provide better pain control than CWI on pain relief after surgery.
Authors: James Wei Tatt Toh; Geoffrey Peter Collins; Nimalan Pathma-Nathan; Toufic El-Khoury; Alexander Engel; Stephen Smith; Arthur Richardson; Grahame Ctercteko Journal: Langenbecks Arch Surg Date: 2022-03-11 Impact factor: 2.895