Introduction of continuous regional analgesia via wound catheters in a peripheral hospital.
OBJECTIVE
To review the effectiveness of continuous regional analgesia (CRA) via wound catheters after abdominal surgery in a district general hospital (Wanganui, New Zealand).


METHODS
Retrospective review of postoperative analgesia after CRA via wound catheters was introduced (April 2008 to December 2008). Pain scores, HDU stay, opiate use and complications were recorded.


RESULTS
Fifty-four patients' notes have been reviewed after elective and emergency laparotomies. Twenty-seven had WC (± patient controlled analgesia [PCA]), 15 had PCA only, 12 had epidural (± PCA). Resting pain scores were nil or zero in 18/27 (66.7%) wound catheter, 9/15 (60%) PCA and 5/12 (41.7%) epidural patients. Moderate/severe pain on movement was scored in patients 5/27 (18.5%) with wound catheter, 6/15 (40%) with PCA, 5/12 (41.7%) with epidural catheters. A single PCA syringe lasted over 24 hours in 18/27 (66.7%) wound catheter, 6/15 (40%) PCA, and 5/8 (63%) epidural + PCA patients. Eight adverse effects were seen; 4 wound infections (2 wound catheter, 1 PCA, 1 epidural patient) and 4 blockages of epidural catheters in epidural group. No adverse effect was found directly related to the WC.


CONCLUSIONS
Continuous regional analgesia via wound catheters provides effective and safe postoperative analgesia for surgical patients in a small district general hospital. Used as part of a multimodal approach it allows easy step-down from HDU to surgical wards. This technique has been readily accepted over the year by theatre, HDU, ward, and anaesthetics colleagues.
Department of Surgery, Wanganui Hospital, Wanganui, New Zealand. etaung@yahoo.com.
Ei Thu
ET
Aung
Pascale
P
Fluri
Semisi
S
Aiono
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000765:Anesthesia, Conduction / Q000295:instrumentation*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002404:Catheterization / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006780:Hospitals, Rural; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010147:Pain Measurement; D010149:Postoperative Pain / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000779:Anesthetics, Local