Continuous local anaesthetic wound infusion of bupivacaine for postoperative analgesia in neonates: a randomised control trial (CANWIN Study).
BMJ Paediatr Open
; 6(1)2022 08.
Article
em En
| MEDLINE
| ID: mdl-36053616
ABSTRACT
OBJECTIVE:
To determine the effect of continuous wound infusion of local anaesthetic drug (bupivacaine) on total amount of systemic opioid use in the first 72 hours in newborn infants undergoing laparotomy.DESIGN:
A two-arm parallel, open-label randomised controlled trial.SETTING:
A quaternary newborn intensive care unit. PATIENTS Infants>37 weeks of gestation undergoing laparotomy for congenital or acquired abdominal conditions.INTERVENTIONS:
Continuous wound infusion of local anaesthetic (bupivacaine) for the first 72 hours along with systemic opioid analgesia (catheter group) or only systemic opioid analgesia (opioid group). MAINOUTCOME:
Total amount of systemic opioid used within the first 72 hours post laparotomy.RESULTS:
The study was underpowered as only 30 of the expected sample size of 70 infants were enrolled. 16 were randomised to catheter group and 14 to opioid group. The two groups were similar at baseline. There was no significant difference between the groups for the primary outcome of median total systemic opioid use in the first 72 hours post laparotomy (catheter 431.5 µg/kg vs opioid 771 µg/kg, difference -339.5 µg/kg, 90% CIhigh 109, p value 0.28). There was no significant difference between the groups for any of the secondary outcomes including pain scores, duration of mechanical ventilation, time to reach full feeds and duration of hospital stay. There were no adverse events noted.CONCLUSION:
Continuous wound infusion of local anaesthetic along with systemic opioid analgesia is feasible. The lack of a difference in total systemic opioid use in the first 72 hours cannot be reliably interpreted as the study was underpowered. TRIAL REGISTRATION NUMBER ACTRN12610000633088.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Analgesia
/
Transtornos Relacionados ao Uso de Opioides
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article