British Journal of Anaesthesia, Vol 81, Issue 3 377-383, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia
S. Moiniche, S. Mikkelsen, J. Wetterslev and J. B. Dahl
In a qualitative systematic review, we have evaluated randomized controlled
trials (RCT) of incisional local anaesthesia compared with placebo or no
treatment in the control of postoperative pain after open abdominal
operations. Twenty-six studies with data from 1211 patients were considered
appropriate for analysis. Five RCT considered inguinal herniotomy, four
hysterectomy, eight cholecystectomy and nine studies a variety of surgical
procedures. Outcome measures were pain scores, supplementary analgesics and
time to first analgesic request. Efficacy was estimated by significant
difference (P < 0.05), as reported in the original investigation. All
studies of herniotomy showed a 2-7-h duration of clinically relevant
improved pain relief. Results of hysterectomy studies were inconclusive,
with two being negative. Five of the cholecystectomy studies showed
significant differences but questionable clinical importance and validity
in three. In various other procedures results were inconsistent and in some
of minor clinical importance. Except for herniotomy, there was a lack of
evidence for effect of incisional local anaesthesia on postoperative pain
and further standardized studies are needed before recommendations can be
made.
CLINICAL INVESTIGATIONS
A qualitative systematic review of incisional local anaesthesia for postoperative pain relief after abdominal operations
Department of Anaesthesiology, Hvidovre University Hospital, DK-2650 Hvidovre, Copenhagen, Denmark; Department of Anaesthesiology, Herlev University Hospital, DK-2730, Herlev, Denmark
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