Surgical Versus Anaesthetic Placement of Rectus Sheath Catheters

Launched by COUNTESS OF CHESTER NHS FOUNDATION TRUST · Apr 28, 2017

Keywords

ClinConnect Summary

Background and study aims Pain management post laparotomy (abdominal surgery) can be difficult and in our trust we are increasingly using rectus sheath catheters (RSCs).This is achieved by placing catheters, done by either by the surgeon or anaesthetist into the potential space between the rectus muscle and the posterior rectus sheath. Two catheters are placed, one on either side of the mid-line wound. Local anaesthetic is then infused through the catheters for up to 3 days post-operatively. This provides analgesia to the central abdominal wall in the region of the T7-T11 dermatomes. It onl...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients aged over 18 years
• • Able to provide informed consent
• • Undergoing elective, open colorectal surgery or emergency laparotomy via a midline incision extending above the umbilicus
• • Weight of 50kg or over to standardise the analgesia given.
• Exclusion Criteria:
• • Weight of less than 50kg
• • Patients unable to consent
• • Age under 18 years
• • Inability to insert RSC - local infection or severe coagulopathy
• • Allergy to local anaesthetic
• • Chronic pre-operative use of strong opioids or gabapentins and or chronic pain syndromes