title: [Continuous infusion of local anesthetic at the site of the abdominal surgical wound for postoperative analgesia: a systematic review].
abstract: OBJECTIVE
  We present a systematic review of clinical trials to evaluate the efficacy of infusing local anesthetic through a catheter placed in the abdominal surgical wound.
  
  
  METHODS
  The Jadad (Oxford) scoring system was used to select trials. The variables considered in relation to each trial selected were as follows: type of intervention and incision; type, dose, and concentration of local anesthetic; site where the catheter was placed; rescue analgesia required; opioid use; and incidence of adverse events.
  
  
  RESULTS
  Fifteen clinical trials with a mean Jadad score of 4.6 were selected. The 1139 patients enrolled in the trials were grouped according to catheter placement: subfascial (6 trials), subcutaneous (8 trials), and both (1 trial). Six additional unpublished trials registered at ClinicalTrials.gov were also located.
  
  
  CONCLUSIONS
  Surgical wound analgesia is a safe technique whose effectiveness has been observed in cesarean sections and hysterectomies performed with Pfannenstiel incisions. Outcomes for other types of surgery are inconsistent. There is a lack of studies of the optimal site for catheter placement as well as of adequate anesthetic concentration and volume.
authors.affiliation: Servicio de Anestesiologia y Reanimacidn, Hospital Universitario de Bellvitge, Idibell, Barcelona.
authors.forename: N
authors.initials: N
authors.lastname: Fustran Guerrero
authors.forename: A
authors.initials: A
authors.lastname: Dalmau Llitjós
authors.forename: A
authors.initials: A
authors.lastname: Sabaté Pes
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000698:Analgesia / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D006801:Humans; D036502:Infusions, Intralesional; D010149:Postoperative Pain / Q000517:prevention & control*
chemical_list: D000779:Anesthetics, Local