Continuous wound infusion as an alternative to continuous epidural infusion for postoperative analgesia in renal transplant surgery: A prospective randomized controlled trial

Background: Pain management is often challenging in patients undergoing renal transplant owing to the various comorbidities. Epidural analgesia is currently the standard technique but is not without complications. Continuous wound infusion (CWI) is emerging as a simple and effective technique of postoperative analgesia. Therefore, the purpose of our study was to compare the efficacy of CWI with continuous epidural infusion (CEI). Methods: Forty-two patients undergoing renal transplant surgery were randomized to receive either CEI or CWI. The visual analogue score at rest and on movement was assessed. Opioid consumption, patient satisfaction, and complications were also assessed. Results: The pain scores measured at rest 4, and 8 h postoperatively were significantly lower in the CWI group.(2.45 +/- 1.317) in CWI versus (3.45 +/- 1.050) in CEI, P = 0.012 at 4 h, and (1.95 +/- 1.146) in CWI versus (2.75 +/- 0.786) in CEI, P = 0.014 at 8 h. The pain scores at other time points were lower in the CWI group but not statistically significant. The morphine used in the first 8 h was significantly higher in the CEI group. There was a higher incidence of hypotension in the CEI group (P = 0.028). The patient satisfaction and other side effects were comparable between the groups. Conclusion: Continuous wound infiltration is an effective technique for postoperative analgesia in renal transplant surgery and can be used as an alternative to epidural analgesia.