ESRA Academy. McMorrow F. Sep 8, 2016; 138444
Dr. Fintan McMorrow
Dr. Fintan McMorrow

Access to Premium content is currently a membership benefit.

Click here to join ESRA or renew your membership.

Discussion Forum (0)
Rate & Comment (0)
Background and Aims:

Wound catheters offer potential benefits in postoperative pain management and avoid the side-effect profile associated with traditional means, such as thoracic epidurals.

We present our experience with the use of wound catheters in major abdominal procedures, a new addition to the enhanced recovery protocol within our institution.


Data was collected retrospectively on all patients undergoing major hepatobiliary surgery between February 2014 & October 2015 via a rooftop incision.  Each received intrathecal morphine at a dose up to 0.01mg/kg pre-operatively. Two multi-holed wound catheters were placed by the surgeon between anterior and posterior rectus sheath, and one elastomeric pump attached delivering a 10ml/hour infusion of 0.125% levo-bupivacaine over 72 hours. A morphine patient-controlled analgesia (PCA) pump was used post-operatively.


Seventy-one patients underwent surgery but complete data is available for 55 patients (77%). Average age was 60 (range 34-79 years) and 56% of patients were male. Average intrathecal morphine dose was 600micrograms (range 300-1000mcg). Average morphine consumption at 24 hours was 41mg (range 1mg-152mg). Five PCA’s were discontinued by 48 hours. Average total morphine consumption at 48 hours was 80mg (range 7mg-300mg). Twenty-five PCA’s were discontinued by 72 hours. Average total morphine consumption at 72 hours was 137mg (range 7mg-380mg). 95% of patients went to HDU post-operatively with an average stay of 6 days (range 3-27 days). Average total hospital stay was 15 days with 30-day mortality of 1.8%.


Wound catheters appear to markedly reduce intravenous morphine consumption and are an essential constituent of multi-modal analgesia in our institution’s hepatobiliary enhanced recovery package.

Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.

Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.

Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.

Save Settings