Impact of epidural versus wound catheter analgesia for patients undergoing open pancreatoduodenectomy: A randomized controlled trial.
PancreatologyJul 7, 2026 (epub)
Piia M Peltoniemi, Teija M Nieminen, Hanna I S Belfrage et al.
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In 30 seconds
This randomized controlled trial compared thoracic epidural analgesia (TEA) and continuous wound infusion (CWI) in 116 patients undergoing open pancreatoduodenectomy. TEA resulted in higher norepinephrine consumption on postoperative day 0 (3.7 vs 2.0 mg, P < 0.001) and greater fluid administration in the post-anesthesia care unit (4.0 vs 3.0 ml/kg/h, P < 0.001), but both methods had similar complication rates and hospital stays.
Key findings
- TEA led to higher norepinephrine use on POD 0 (3.7 vs 2.0 mg, P < 0.001).
- Fluid administration was greater with TEA in the post-anesthesia care unit (4.0 vs 3.0 ml/kg/h, P < 0.001).
- Severe complications were similar between TEA (15.5%) and CWI (22.4%), P = 0.48.
- TEA provided better analgesia on POD 1 (NRS 2.4 vs 3.9, P = 0.004).
Why it matters
Understanding the impact of different analgesic techniques on fluid management and complications is crucial for optimizing postoperative care in patients undergoing complex surgeries like pancreatoduodenectomy.