Recovery was quite slow as I suffered a lot of nerve and muscle pain. I had an upper left lobectomy at the end of October. I was diagnosed with non small lung cancer in September 2014, I was lucky like yourself that it was caught early, my tumour was 1.6 cm by 1.8cm. Changes in pain from baseline to M3 and residual pain. Pain was measured by a visual analog scale (VAS 0 no pain 100 mm most severe pain). Upon acceptance of an article for publication, the authors will be asked to complete the ICMJE “Copyright Liability and Copyright Sharing Statement “() and the “Declaration of Potential Conflicts of Interest” ( An e-mail will be sent to the corresponding author to acknowledge receipt of the manuscript.Īfter publication, the authors are authorised to make their articles available in repositories of their institutions of origin, as long as they always mention where they were published and according to the Creative Commons license.Hi Karen, I'm not sure if you still use this site, I'm hoping you do as my story is similar to yours. Residual pain was considered as pain in pts with complete attenuation of inflammation at M3, defined by a swollen joint count (SJC) of 0 and CRP levels < 6 mg/L. It is the author’s responsibility to obtain approval for the reproduction of figures, tables, etc. The AMP is governed by the terms of the Creative Commons ‘Attribution – Non-Commercial Use - (CC-BY-NC)’ license, regarding the use by third parties. This technique is associated with better analgesia, lower incidence of side effects, high level of satisfaction and no residual pain, contributing to enhanced recovery.Ĭonclusion: Continuous wound infusion is an effective technique, which should be implemented for analgesia after major abdominal surgery, with advantages when compared with epidural analgesia, especially low incidence of adverse effects.Īll the articles published in the AMP are open access and comply with the requirements of funding agencies or academic institutions. There was one case of systemic local anesthetic toxicity with an episode of frequent ventricular extrasystoles without hemodynamic instability, which ceased after suspension of continuous epidural infusion of local anesthetic.ĭiscussion: This study suggests that continuous wound infusion is the technique with most efficacy and safety, being even better than epidural analgesia in postoperative pain control after major abdominal surgery. The incidence of nausea, vomiting, pruritus or íleus was lower in the continuous wound infusion group, with statistically significant results for recovery of intestinal function. Within the continuous wound infusion group with uncontrolled pain, all patients rated the pain below 6/10 24 hours postoperatively. Results: The proportion of patients with successful control of postoperative pain was 84% against 60% with epidural analgesia and continuous wound infusion, respectively. Scores of pain at six, 12 and 48 hours and three months after surgery were also evaluated, as well as the incidence of adverse effects 48 hours postoperatively. The primary outcome was analysis of pain at rest (< 4/10 numerical pain scale) after 24 hours postoperatively. Material and Methods: Fifty patients, previously subjected to abdominal surgery by median laparotomy with xifo-pubic incision were randomized to receive postoperative analgesia via epidural (n = 25) or via continuous wound infusion (n = 25) during 48 hours. The optimization of postoperative analgesia improves prognosis contributing also to patient satisfaction and reducing morbidity and mortality. The aim of this randomized control study is to perform the comparative analysis in terms of effectiveness of an unconventional and still poorly technique implemented, continuous wound infusion, and the currently most applied and gold standard technique, epidural analgesia, in the postoperative period after abdominal surgery. Introduction: The Management of postoperative pain after abdominal surgery is a major challenge to the anesthesiologist. Portugal.Ībdomen/surgery, Anesthesia, Epidural, Anesthetics, Local, Digestive System Surgical Procedures, Pain, Postoperative, Postoperative Complications, Postoperative Nausea and Vomiting Abstract
RESIDUAL PAIN TRIAL
PAMA Trial - PAin MAnagement, Satisfaction, Adverse Effects and Risk of Local Infection after Major Open Abdominal Surgery: Epidural versus Continuous Wound Infusion.
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