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.
Reference: Karthikesalingam A, Walsh SR, Markar SR, Sadat U, Tang TY, Malata CM. Continuous wound infusion of local anaes¬thetic agents following colorectal surgery: Systematic review and meta-analysis. World J Gastroenterol 2008; 14(34): 5301-5305
http://www.wjgnet.com/1007-9327/14/5301.asp
Correspondence to: Stewart R Walsh, Department of Genereal Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Specialist Registrar in General Surgery, Box 201, Level 7, Hills Road, Cambridge CB2 2QQ, United Kindom. srwalsh@doctors.org.uk
telephone:+44-1223-217246 Fax: +44-1223-216015
About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection. It provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the title China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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World Journal of Gastroenterology