CWI Analgesics versus Continuous Intravenous Fentanyl after Gynecological Surgery

A new study aimed to demonstrate that continuous wound infiltration (CWI) is not inferior to continuous intravenous fentanyl (IV) in providing pain relief, and also compared the safety of the two methods. 

This prospective, single-center, two-arm, non-inferiority, randomized controlled trial that analyzed 59 patients. All participants were allotted either the CWI group or IV group. The visual analog scale (VAS), additional analgesic usage, and side effects were compared between the groups.

It was noted that the difference in the pain scores (VAS) at 24 hours between the CWI and IV groups was within an acceptable margin for non-inferiority. Additionally, the amount of fentanyl used in the CWI group was significantly lower than in the IV group at 48 hours postoperatively – suggesting an opioid-sparing effect for CWI in open gynecological surgeries. Additional analgesic use and adverse effects incidence were not significantly different between the two groups. 

Hence, CWI was found to be non-inferior to IV in terms of analgesic efficacy and demonstrated an opioid-sparing effect in the context of open gynecological surgery.

Source: Kuriyama M, Nakamura H, Tanabe S, Morikawa Y, Kaneko T, Kohyama A. BJOG: An International Journal of Obstetrics & Gynaecology. 2023 Nov;130(12):1459-65.