Effect of continuous anesthetic wound infusion on postoperative activity in patients who underwent midline laparotomy for gynecological diseases

Objective This study aimed to assess whether continuous anesthetic wound infusion (CAWI) increases postoperative activity in patients who undergo midline laparotomy for gynecological diseases. Methods This was an unplanned secondary analysis of a randomized controlled trial examining the effect of an activity tracker with feedback on postoperative activity in patients who underwent midline laparotomy for gynecological diseases ( NCT02025387 ). Of the 53 patients included in the trial (12 patients used CAWI and 41 patients did not), 11 patients with CAWI (case group) and 11 without CAWI (control group) were selected by matching the duration of surgery. We compared the postoperative activity and other endpoints between the case and control groups. Results The case and control groups had similar baseline and surgical characteristics. The recovery rate on postoperative day 4 (step counts at day 4/ daily step counts at preoperative baseline) of the case group was numerically higher, but not significantly different from that of the control group (58% vs. 44%; p=0.450). Least, average and present pain on postoperative day 2 were lower in the case group than in the control group. Pain on postoperative day 5, fatigue, gas out, soft blend diet initiation, ileus, and length of hospital stay were similar between the case and control groups. Conclusions In this exploratory analysis, CAWI was not associated with increased postoperative activity in patients who underwent midline laparotomy for gynecological diseases.