ESRA Academy. Tameem A. Sep 8, 2016; 138347; 0183 Topic: ADJUVANT DRUGS
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Dr. Alifia Tameem
Dr. Alifia Tameem

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Background and Aims:

The comparative efficacy of rectus sheath catheter (RSC) use for abdominal surgeries is yet to be proven. This study evaluates our current practice using RSC following midline laparotomy


Using a standard proforma, demographics, pain scores and opioid use up to 3 post-operative days were retrospectively recorded. The pain score was a numerical rating scale of 0-3 (0 no pain, 1 mild pain, 2 moderate pain, 3 severe pain). All RSC infusions followed the trust protocol of 10ml/hour 0.2% ropivacaine, 10ml bolus and 2 hour lockout.


20 patients who had undergone a laparotomy with RSC placed intra-operatively were identified. 19 patients had general anaesthetic only, 1 had a combined general and spinal anaesthetic. The median age was 69 (25-86), 11 males, 9 females. 13 patients were elective and 7 emergency laparotomy. There were no reported adverse effects from the RSC. 9 patients had morphine PCA in addition to RSC.  

Post-operative pain scores were low (figure 1). The number of patients requiring post-operative opioid in addition to RSC is shown in figure 2. The total dose of morphine required is shown in table 3.


Low pain scores were reported suggesting RSC provides effective post-operative analgesia. Most had low opioid requirements with only 2 patients requiring higher doses via PCA. We are not advocating superiority to epidural analgesia, but a safe and effective alternative where neuroaxial blockade is contraindicated. We also propose an opioid sparing effect and role in multimodal analgesia for those with established chronic pain.

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