Local anesthetic infiltration

Local anesthetic infiltration at the site of a surgical wound is commonly used to control postoperative pain.

Lee et al. examined the effectiveness of continuous local anesthetic infiltration at an abdominal surgical site in patients undergoing anterior lumbar interbody fusion (ALIF) surgery.

Sixty-one patients who underwent ALIF surgery were enrolled. For thirty-one of them, a continuous local anesthetics infiltration system was used at the abdominal site. They collected data regarding the patients' sleep quality; satisfaction with pain control after surgery; abilities to perform physical tasks and the additional application of opioids in the postoperative 48 hours.

The On-Q system group showed reduced visual analog scale scores for pain at the surgical site during rest and movement at 0, 12, 24, and 48 hours; and more were satisfied with pain control management at the first postoperative day (7.0 ± 1.2 vs. 6.0 ± 1.4; P = 0.003) and week (8.1 ± 1.6 vs. 7.0 ± 1.8; P = 0.010) than the control group. The number of additional patient-controlled analgesia (PCA) bolus and pethidine injections was lower in the On-Q group (PCA: 3.67 ± 1.35 vs. 4.60 ± 1.88; P = 0.049 and pethidine: 2.09 ± 1.07 vs. 2.73 ± 1.38; P = 0.032). Patients who used the On-Q system performed more diverse activity and achieved earlier ambulation than those in the control group.

Continuous wound infiltration with ropivacaine using an On-Q system may be effective for controlling postoperative pain after ALIF surgery ¹⁾