Related Experiment Video
Updated: Jun 8, 2026
An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
Improving continuous wound infusion effectiveness for postoperative analgesia after cesarean delivery: a randomized
Thibaut Rackelboom1, Solenn Le Strat, Stephane Silvera
1From Department of Anesthesiology and Intensive Care, Department of Radiology, Department of Obstetrics and Gynecology, Maternité Port-Royal, France; University Paris Descartes; Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Anesthesiology and Intensive Care, Saint-Antoine University Hospital, Assistance Publique-Hôpitaux de Paris, University Pierre et Marie Curie Paris 6; Paris, France.
Objective:
To evaluate in which anatomical layer (above the fascia or below the fascia) continuous wound infusion of local anesthetic, combined with nonsteroidal antiinflammatory drugs, through a multiorifice catheter has the best effectiveness during the first 48 hours on postoperative pain intensity after elective cesarean delivery.
Methods:
Fifty-six women undergoing elective cesarean delivery under spinal anesthesia were randomly allocated to receive 48-hour continuous wound infusion either above the fascia or below the fascia using ropivacaine and ketoprofene through a multiholed wound catheter. No other systemic analgesics were used, except for rescue patient-controlled intravenous morphine. Evaluation by a blinded investigator included visual analog scale scores at rest and at movement, morphine consumption, patient satisfaction, residual pain at 1 and 6 months, and undesirable side effects.
Results:
Continuous wound infusion below the fascia resulted in significantly reduced pain at rest and total postoperative morphine consumption (15.7 mg, 95% confidence interval 9.7-20.7 mg) compared with wound administration above the fascia (26.4 mg, 95% confidence interval 18.1-34.7). No undesirable side effects or residual pain requiring treatment were recorded in both groups, whereas analgesia and satisfaction were excellent.
Conclusion:
After cesarean delivery, continuous wound infusion over 48 hours with ropivacaine and ketoprofene through a multiholed wound catheter inserted below the fascia results in better analgesia when compared with administration above the fascia.
Clinical Trial Registration:
ClinicalTrials.gov, www.clinicaltrials.gov, NCT01160913.
Level Of Evidence:
I.
