title: Rectus sheath catheters provide equivalent analgesia to epidurals following laparotomy for colorectal surgery.
abstract: Introduction Rectus sheath catheters (RSCs) are increasingly being used to provide postoperative analgesia following laparotomy for colorectal surgery. Little is known about their efficacy in comparison with epidural infusion analgesia (EIA). They are potentially better as they avoid the recognised complications associated with EIA. This study compares these two methods of analgesia. Outcomes include average pain scores, time to mobilisation and length of stay. Methods This was a 33-month single centre observational study including all patients undergoing elective open or laparoscopic-converted-to-open colorectal resection for both benign and malignant disease. Patients received either EIA or RSCs. Data were collected prospectively and analysed retrospectively. Results A total of 95 patients were identified. Indications for surgery, operation and complications were recorded. The mean time to mobilisation was significantly shorter in patients who had RSCs compared with EIA patients (2.4 vs 3.5 days, p<0.05). There was no difference in postoperative pain scores or length of stay. Conclusions RSCs provide equivalent analgesia to EIA and avoid the recognised potential complications of EIA. They are associated with a shorter time to mobilisation. Their use should be adopted more widely.
authors.affiliation: Taunton and Somerset NHS Foundation Trust , UK.
authors.forename: E C G
authors.initials: EC
authors.lastname: Tudor
authors.affiliation: Taunton and Somerset NHS Foundation Trust , UK.
authors.forename: W
authors.initials: W
authors.lastname: Yang
authors.affiliation: Taunton and Somerset NHS Foundation Trust , UK.
authors.forename: R
authors.initials: R
authors.lastname: Brown
authors.affiliation: Taunton and Somerset NHS Foundation Trust , UK.
authors.forename: P M
authors.initials: PM
authors.lastname: Mackey
mesh_terms: D015360:Analgesia, Epidural; D002404:Catheterization; D003082:Colectomy; D003108:Colonic Diseases / Q000601:surgery; D005260:Female; D006801:Humans; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000517:prevention & control*; D012002:Rectal Diseases / Q000601:surgery; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Analgesia; Colorectal surgery; Epidural; Laparotomy; Rectus sheath catheter