Evidence map›Paper›PMID 40465133›Full record

Trial reportPaediatric drugs2025

Efficacy and Safety of Wound Catheter Infusion with Ropivacaine After Abdominal Surgery in Children Aged < 1 Year: A Randomized Controlled Trial.

Lonneke M Staals, Jaap Dogger, Claudia Keyzer-Dekker, Anneke A Boerlage, Eric F Bokhorst, Jan J van Wijk, Jeroen R Scheepe, Monique van Dijk, Joost van Rosmalen, Saskia N de Wildt

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Paediatric drugs, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Lonneke M StaalsDepartment of Anesthesiology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Dr. Molewaterplein 40, PO Box 2060, 3000 CB, Rotterdam, The Netherlands. l.staals@erasmusmc.nl.ORCID http://orcid.org/0000-0001-7867-971X
Jaap DoggerDepartment of Anesthesiology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Dr. Molewaterplein 40, PO Box 2060, 3000 CB, Rotterdam, The Netherlands.
Claudia Keyzer-DekkerDepartment of Pediatric Surgery, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Anneke A BoerlageDepartment of Anesthesiology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Dr. Molewaterplein 40, PO Box 2060, 3000 CB, Rotterdam, The Netherlands.
Eric F BokhorstDepartment of Neonatal and Pediatric Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.
Jan J van WijkDepartment of Anesthesiology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Dr. Molewaterplein 40, PO Box 2060, 3000 CB, Rotterdam, The Netherlands.
Jeroen R ScheepeDepartment of Urology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.
Monique van DijkDepartment of Neonatal and Pediatric Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.
Joost van RosmalenDepartment of Biostatistics, Erasmus MC, Rotterdam, The Netherlands.
Saskia N de WildtDepartment of Neonatal and Pediatric Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.

Funding

Stichting Coolsingel project 484stichting erasmus fonds pijngeneeskunde 15-1441
6 · The paper itself

Abstract

BACKGROUND AND

objectiveWound catheter infusion (WCI) with local anesthetics provides effective postoperative analgesia in adults, without adverse effects on wound healing. Studies on WCI in infants are scarce. The aim of this study was to investigate the efficacy and safety of WCI with ropivacaine as treatment for postoperative pain in infants.

methodsWe conducted a prospective, randomized, double-blind, placebo-controlled trial including children aged < 1 year undergoing open abdominal surgery. Informed consent was obtained. All children received a wound catheter at the end of surgery and were randomized for treatment with either ropivacaine (bolus dose of 2 mg/kg and continuous infusion of 0.2 mg/kg/h) (R-group) or placebo (C-group), for 72 h postoperatively. The C-group received morphine 100 mcg/kg intravenously at the end of surgery, the R-group received placebo. Standard analgesia postoperatively was paracetamol intravenously and rescue morphine intravenously. Primary outcome was the cumulative amount of morphine (mcg/kg) administered in the first 48 hours postoperatively. Secondary outcomes were the number of patients needing morphine, area under the curve over 24 hours of COMFORT-B and Numeric Rating Scale pain scores, incidence of adverse events, and plasma concentrations of ropivacaine.

resultsAfter inclusion of 30 patients, the study was discontinued because of slow recruitment. In two cases, the wound catheter was accidentally displaced directly after surgery, therefore data of 28 children were analyzed (14 R-group, 14 C-group). Median [interquartile range] cumulative amount of morphine (mcg/kg) administered within 48 hours postoperatively was 0.0 [0.0-642.2] in the R-group, compared with 240.1 [15.1-759.0] in the C-group (P = 0.068). In the R-group, 6/14 children required morphine compared with 13/14 in the C-group (P = 0.013). Pain scores were not significantly different between groups. Plasma concentrations of ropivacaine stayed below toxic thresholds.

conclusionsCumulative morphine use postoperatively was not significantly different between infants receiving WCI with ropivacaine or placebo, although a lower number in the R-group required morphine. Wound catheter infusion provided adequate analgesia, with no signs of local anesthetic toxicity. The study may have been underpowered because of early discontinuation. CLINICAL

trial registrationThe study was registered in EudraCT (2015-002209-12), and the Dutch Trial Registry NTR6130 on 23 November, 2016 (International Clinical Trials Registry Platform NL-OMON20504).

Indexed as

AbdomenAnesthetics, LocalPostoperative PainRopivacaineDouble-Blind MethodFemaleHumansInfantMaleMorphinePain MeasurementProspective StudiesTreatment OutcomeAnesthetics, LocalMorphineRopivacaine

Identifiers

PMID40465133
PMCPMC12378887

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.