{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T21:06:42Z","timestamp":1777756002198,"version":"3.51.4"},"reference-count":44,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To evaluate comparative outcomes of wound infusion catheter (WC) vs epidural analgesia (EP) for analgesia following midline laparotomy for abdominal surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed, Cochrane Library, and Scopus was conducted, and all randomised controlled trials (RCTs) comparing WC vs EP for analgesia after midline laparotomy were included. Overall pain scores, total morphine consumption, respiratory depression, catheter-related complications, time of first bowel movement, and length of hospital stay (LOS) were set as outcome parameters for the meta-analysis. Subgroups of catheter positions, including preperitoneal, rectus sheath and transversus abdominis plane block as deep WC and subcutaneous WC, were examined for pain scores superiority.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twelve RCTs were pooled in a meta-analysis, involving a total of 778 patients who received WC (n = 390) or EP (n = 388). There was no significant difference in pain scores at rest and movement between WC and EP groups at 24 hours [\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .85 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .30, respectively] and 48 hours [\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .33 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .06, respectively]. However, subgroup analysis, excluding subcutaneous catheters, showed favourable pain scores on movement at 48 hours of use (mean difference [MD] \u22120.97,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .03). The LOS was notably shorter in the WC group [MD, \u22120.50;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001]. There were no significant differences between both groups in cumulative morphine consumption [\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .33], return of bowel function [\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .13], respiratory depression [\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .43], or catheter-related complications [\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .16].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>WC generally provides a comparable postoperative analgesia to EP; however, it is associated with shorter LOS and a slight superiority of analgesia of deep catheters. Comparing different types of nerve blocks and positions of catheters in future research may optimise the use of WC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251409737","type":"journal-article","created":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T08:53:10Z","timestamp":1766220790000},"page":"1673-1685","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Wound Infusion Catheter Versus Epidural Catheter for Analgesia After Midline Incision for Major Abdominal Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials"],"prefix":"10.1177","volume":"92","author":[{"given":"Mohamed","family":"Albendary","sequence":"first","affiliation":[{"name":"University Hospitals of Leicester NHS Trust"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hussam Khougali","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Wrexham Maelor Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salma Saeed","family":"Mohammed","sequence":"additional","affiliation":[{"name":"University Hospitals of Leicester NHS Trust"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dina","family":"Nada","sequence":"additional","affiliation":[{"name":"University Hospitals of Leicester NHS Trust"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1971-7303","authenticated-orcid":false,"given":"Asaad Yassin","family":"Mohamedahmed","sequence":"additional","affiliation":[{"name":"Arar Central Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Refaie","sequence":"additional","affiliation":[{"name":"Glan Clwyd Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Elaraby","sequence":"additional","affiliation":[{"name":"Glan Clwyd Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1219-7571","authenticated-orcid":false,"given":"Ali Yasen","family":"Mohamedahmed","sequence":"additional","affiliation":[{"name":"University Hospitals of Coventry and Warwickshire NHS Trust"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,20]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2021-103098"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2011.12.002"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2010.02.011"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","unstructured":"Pirie K Traer E Finniss D Myles PS Riedel B. 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