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.

This article systematically reviews and meta-analyzes randomized controlled trials comparing wound infusion catheters (WC) with epidural analgesia (EP) for postoperative pain management following midline laparotomy in abdominal surgery. The analysis of 12 trials involving 778 patients found no significant difference in overall pain scores or morphine consumption between WC and EP groups, though deep tissue WC placements (preperitoneal, rectus sheath, transversus abdominis plane) showed slightly better pain control on movement at 48 hours. WC use was associated with a significantly shorter length of hospital stay and comparable safety profiles regarding respiratory depression, bowel function recovery, and catheter-related complications. The findings suggest WC as a viable and potentially advantageous alternative to EP, with recommendations for future research to standardize techniques and further evaluate functional recovery outcomes.