BACKGROUND: @entity282 prevention is essential for the recovery of surgical @entity1 . Continuous (thoracic) epidural @entity1337 ( @entity787 ) is routinely practiced for major abdominal surgery, but evidence is conflicting on its benefits in this setting. Potential disadvantages of epidural @entity1337 are a) perioperative @entity551 , frequently requiring additional intravenous fluid boluses or prolonged use of vasopressors; b) relatively high failure rates, with periods of inadequate @entity1337 ; and c) the risk of rare but serious, at times persistent, neurologic complications ( @entity1410 and @entity733 ). In recent years, @entity2617 (CWI) plus @entity1 -controlled @entity1337 (PCA) has been suggested as a safe and reliable alternative, which does not have the previously mentioned disadvantages, but evidence from multicenter trials targeting a specific surgical population is lacking. We hypothesize that CWI+PCA is equally as effective as @entity787 , without the mentioned disadvantages. METHODS/DESIGN: POP-UP is a randomized controlled noninferiority multicenter trial, recruiting adult @entity1 scheduled for elective hepato-pancreato-biliary surgery via laparotomy in an enhanced recovery setting. A total of 102 @entity1 are being randomly allocated to CWI+PCA or (P) @entity787 . Our primary endpoint is the Overall Benefit of Analgesic Score (OBAS), a composite endpoint of @entity158 intensity, opioid-related adverse effects and @entity1 satisfaction, during postoperative days 1 to 5. Secondary endpoints include length of the hospital stay, number of @entity1 with severe @entity158 , and the use of rescue medication. DISCUSSION: POP-UP is a pragmatic trial that will provide evidence of whether CWI+PCA is noninferior as compared to (P) @entity787 after elective hepato-pancreato-biliary surgery via laparotomy in an enhanced recovery setting. If this hypothesis is confirmed, this finding could contribute to more widespread implementation of this technique, especially when the described disadvantages of epidural @entity1337 are less often observed with CWI+PCA. TRIAL REGISTRATION: Netherlands Trial Register NTR4948 (registry date 2 January 2015).

Continuous wound infiltration or epidural @entity1337 for XXXX prevention after hepato-pancreato-biliary surgery within an enhanced recovery program (POP-UP trial): study protocol for a randomized controlled trial.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity2617 :: ('MESH:D017254', 'Disease') :: ['continuous (subfascial) wound infiltration'] @entity1337 :: ('MESH:D000699', 'Disease') :: ['analgesia'] @entity787 :: ('1084', 'Gene') :: ['CEA'] @entity1410 :: ('MESH:D006406', 'Disease') :: ['hematoma'] @entity733 :: ('MESH:D000038', 'Disease') :: ['abscess'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity551 :: ('MESH:D007022', 'Disease') :: ['hypotension'] @entity282 :: ('MESH:D010149', 'Disease') :: ['Postoperative pain']
@entity158 :: (MESH:D010146,Disease) :: ['pain']
