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Letters to the Editor: Letters & Announcements

In Response

O'Neill, Patrícia MD; Duarte, Filipa MD

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doi: 10.1213/ANE.0b013e318263c758
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We agree with Drs. Bhatia and Sen1 that a protocol including more than one group per treatment regimen would have been preferable. However, it was not possible at the time in the institution.

The best continuous wound infusion regimen regarding selection, concentration, infusion rate of local anesthetic, and adjuvants is yet unknown and these are open areas for future investigation.

Despite having used a single dose of intermittent epidural morphine, we concluded that in our study the continuous wound infusion with ropivacaine after an initial loading dose provided better analgesia with fewer side effects and reduced nursing interventions.2 These results do not aim to generalize but point to an alternative to epidural analgesia for cesarean delivery with potentially fewer risks and side effects.

Patrícia O'Neill, MD

Filipa Duarte, MD

Anesthesiology Department

Hospital Beatriz Ângelo

Loures, Portugal

[email protected]


1. Bhatia N, Sen I. Role of adjuvants in continuous wound infusion analgesia for cesarean deliveries. Anesth Analg 2012;115:735
2. O'Neill P, Duarte F, Ribeiro I, Centeno MJ, Moreira J. Ropivacaine continuous wound infusion versus epidural morphine for postoperative analgesia after cesarean delivery: a randomized controlled trial. Anesth Analg 2012;114:179–85
© 2012 International Anesthesia Research Society