Combined impact of local anaesthetic infiltration through wound catheter and epidural analgesia following surgical hepatectomy: a meta-analysis

Introduction
A meta-analysis was performed to examine the effects of wound catheter (WC) local anaesthetic infiltration (LAI) and epidural analgesia (EA) in open hepatectomy (OH).

Material and methods
A systematic literature review was performed, which found 350 subjects with OH at the baseline of the studies; 159 of them were treated with WC local anaesthetic infiltration, and 191 used EA.

Results
WC LAI substantially reduced the functional recovery time (MD = –0.64; 95% CI, –1.02 to –0.26, p < 0.001) and increased the pain score on the second postoperative day (MD = 0.25; 95% CI: 0.10–0.40, p < 0.001) compared to EA in OH patients. WC LAI did not vary from EA in OH patients in second postoperative opiate use (MD = –14.86; 95% CI: –32.88 to 3.16, p = 0.11) or overall complication rate (OR = 0.66; 95% CI: 0.41–1.04, p = 0.07).

Conclusions
WC LAI showed a non-significant difference in opiate consumption on the second postoperative day and in the overall complication rate, compared with EA, but it showed a lower functional recovery time and higher pain score.