{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:12:54Z","timestamp":1772165574726,"version":"3.50.1"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T00:00:00Z","timestamp":1642464000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T00:00:00Z","timestamp":1642464000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Epidural analgesia is conventionally used as the mainstay of analgesia in open abdominal surgery but has a small life-changing risk of complications (epidural abscesses or haematomas). Local wound-infusion could be a viable alternative and are associated with fewer adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational analysis of individuals undergoing open hepato-pancreato-biliary surgery over 1 year was undertaken. Patients either received epidural analgesia (EP) or continuous wound infusion (WI) + IV patient controlled anaesthesisa (PCA) with an intraoperative spinal opiate. Outcomes analyzed included length of stay, commencement of oral diet and opioid use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between Jan 2016- Dec 2016, 110 patients were analyzed (WI\n                      <jats:italic>n=35<\/jats:italic>\n                      , EP\n                      <jats:italic>n=75<\/jats:italic>\n                      ). The median length of stay (days) was 8 in both the WI and EP group (\n                      <jats:italic>p=0.846<\/jats:italic>\n                      ), the median time to commencing oral diet (days) was 3 in WI group and 2 in EP group (\n                      <jats:italic>p=0.455<\/jats:italic>\n                      ). There was no significant difference in the amount of oromorph, codeine or tramadol (mg) between WI and EP groups (\n                      <jats:italic>p<\/jats:italic>\n                      =\n                      <jats:italic>0.829<\/jats:italic>\n                      ,\n                      <jats:italic>p=0.531, p=0.073,<\/jats:italic>\n                      respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Continuous wound infusion + IV PCA provided adequate analgesia to patients undergoing open hepato-pancreato-biliary surgery. It was non-inferior to epidural analgesia with respect to hospital stay, commencement of oral diet and opioid use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12871-022-01563-2","type":"journal-article","created":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T04:22:59Z","timestamp":1642479779000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Retrospective observational study of patient outcomes with local wound infusion vs epidural analgesia after open hepato-pancreato-biliary surgery"],"prefix":"10.1186","volume":"22","author":[{"given":"A. 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Use of perioperative epidural analgesia among Medicare patients undergoing hepatic and pancreatic surgery. HPB. 2019;21(8):1064\u201371.","journal-title":"HPB."},{"issue":"3","key":"1563_CR2","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1097\/SLA.0000000000002386","volume":"266","author":"TA Aloia","year":"2017","unstructured":"Aloia TA, Kim BJ, Segraves-Chun YS, et al. A Randomized Controlled Trial of Postoperative Thoracic Epidural Analgesia Versus Intravenous Patient-controlled Analgesia After Major Hepatopancreatobiliary Surgery. Ann Surg. 2017;266(3):545\u201354.","journal-title":"Ann Surg"},{"issue":"7","key":"1563_CR3","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1111\/hpb.12183","volume":"16","author":"EM Wong-Lun-Hing","year":"2014","unstructured":"Wong-Lun-Hing EM, van Dam RM, Welsh FK, et al. 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