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Collecting And Measuring Wound Exudate Biochemical Mediators In Surgical Wounds
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Collecting And Measuring Wound Exudate Biochemical Mediators In Surgical Wounds

Published on: October 20, 2012

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Local anesthetic wound infusion versus standard analgesia in paediatric post-operative pain control

M S Machoki1, A J W Millar2, H Albetyn2

  • 1Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, Western Cape, South Africa. stanmugambi@yahoo.co.uk.

Pediatric Surgery International
|September 27, 2015
PubMed

Insights

Continuous local anesthetic wound infusion (CLAWI) effectively manages pediatric post-operative pain, reducing opiate needs. This safe and reliable technique offers improved recovery, including faster mobilization and feeding.

Area of Science:

  • Pediatric Anesthesiology
  • Pain Management
  • Surgical Recovery

Background:

  • Local anesthetic wound infusion shows promise in adults for pain management.
  • Pediatric application of local anesthetic wound infusion is less established, with limited prospective trials.

Purpose of the Study:

  • To evaluate the efficacy and safety of continuous subfascial local anesthetic wound infusion (CLAWI) for post-operative pain control in children undergoing abdominal surgery.
  • To compare CLAWI with epidural bupivacaine (EPI) and standard post-operative analgesia (SAPA) in pediatric patients.

Main Methods:

  • A prospective trial comparing subfascial continuous local anesthetic wound infusion (CLAWI) with bupivacaine to epidural bupivacaine (EPI) and standard analgesia (SAPA).
  • Patients received either CLAWI, EPI, or SAPA, with pain scores and morphine requirements monitored.
  • Secondary outcomes included time to full feeds, urinary catheter duration, and mobilization.

Main Results:

  • CLAWI demonstrated lower average pain scores (2.5) compared to EPI (3.0) and SAPA (3.5).
  • Patients in the CLAWI group required significantly less morphine and had shorter durations for urinary catheter use and mobilization (2 days vs. 4 days).
  • No complications related to the wound or bupivacaine were observed in the CLAWI group.

Conclusions:

  • Continuous subfascial bupivacaine infusion is a safe, reliable, and effective method for pediatric post-operative pain management.
  • CLAWI significantly reduces opioid requirements and improves key recovery parameters in children.
  • This technique offers a valuable alternative for post-operative analgesia in pediatric surgical patients.
Abstract

Keywords:
Abdominal surgeryBupivacaineChildrenLocal anaestheticPaediatricPostoperative analgesiaSub-fascial infusionWound infusion

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