title: Continuous local analgesic therapy reduces pain after radical inguinal/iliacal lymph node dissection.
abstract: BACKGROUND
  To optimize postoperative pain therapy after a radical inguinal/iliacal lymph node dissection (RILND), we investigated the influence of a continuous application of a local anaesthetic via a subfascial wound catheter in the abdominal wall in addition to a standardized systemic analgesia.
  
  
  METHODS
  Between July 2007 and December 2009, 50 patients with stage III/IV of melanoma disease received, in an observational study, a systemic analgesic therapy. Of these patients, 30 were additionally treated with a subfascial catheter. Main outcome criterion was the pain under mobilisation at the first postoperative morning registered via a visual analogue score. Minor criteria were the analgesic requirement, the specific (surgical) complications and the day of discharge.
  
  
  RESULTS
  Patients treated with the subfascial catheter had significant less pain at the first postoperative morning in rest (p = 0.02) and after mobilisation (p = 0.03) without increased morbidity (p = 0.45). Less patients of the treatment group needed a supplementary analgesic medication (p = 0.01) and were able to leave hospital earlier than patients of the control group (p = 0.01).
  
  
  CONCLUSIONS
  A subfascially placed pain catheter enhances postoperative pain therapy after RILND.
authors.affiliation: Department of General, Visceral, Thoracic and Vascular Surgery, Medical Faculty of the Humboldt University Berlin, Charité, Campus Mitte Schumannstrasse 20/21, Berlin, Germany. heiko.neuss@charite.de
authors.forename: Heiko
authors.initials: H
authors.lastname: Neuss
authors.forename: Martin
authors.initials: M
authors.lastname: Schomaker
authors.forename: Wieland
authors.initials: W
authors.lastname: Raue
authors.forename: Gerold
authors.initials: G
authors.lastname: Koplin
authors.forename: Oliver
authors.initials: O
authors.lastname: Haase
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000772:Anesthesia, Local / Q000379:methods*; D016022:Case-Control Studies; D002408:Catheters, Indwelling; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007264:Inguinal Canal / Q000601:surgery; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008297:Male; D008545:Melanoma / Q000556:secondary / Q000601:surgery*; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy*; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid