Continuous preperitoneal versus thoracic epidural analgesia in open pancreatoduodenectomy: randomized clinical trial
Primary result · Mean pain scores at restResult — go to the resultMean difference −0.13 95% CI −0.72 to 0.47Authors' conclusion
CWI was non-inferior to TEA during the early postoperative period, and has emerged as a favourable alternative to TEA, offering better pain relief and enhanced recovery on POD 3.
Study context
- Population
- Adults undergoing elective open pancreatoduodenectomyanalysed
- Participants
- 134 adults
- Comparison
- Continuous wound infiltration (CWI) vs thoracic epidural analgesia (TEA)
- CWIn = 70
- TEAn = 64reference
- Primary endpoint
- Mean pain scores at rest on the first 3 postoperative days (PODs) (11-point NRS); non-inferiority margin ≤1 point
- Follow-up
- First 3 PODs
Methodological detailssingle-centre, open-label, non-inferiority
- Single-centre
- Open-label
- Non-inferiority
Primary result
Mean pain scores at rest
Mean difference
−0.13
95% CI −0.72 to 0.47
CWI vs TEA
mean difference −0.13 (95% CI −0.72 to 0.47)
Non-inferiority margin 1 as printed, not drawn
As reported in the abstract
Secondary outcomes
Pain at rest and quality of recovery scores · POD 3
- CWI superior pain relief at rest and higher-quality recovery scores on POD 3
Total opioid consumption and time to first flatus
- TEA significantly decreased total opioid consumption and shortened time to first flatus vs CWI
Other outcome measures
- No other significant differences between groups
Safety
Postoperative hypotension
- Higher incidence with TEA vs CWI
Original publication
Continuous preperitoneal versus thoracic epidural analgesia in open pancreatoduodenectomy: randomized clinical trial. Br J Surg. Published 27 November 2024. doi:10.
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