Comparison of Post-Operative Analgesic Efficacy of Rectus Sheath Catheter Versus Continuous Wound Infiltration for Laparotomy Surgery

Sakthi Abirami, S (2019) Comparison of Post-Operative Analgesic Efficacy of Rectus Sheath Catheter Versus Continuous Wound Infiltration for Laparotomy Surgery. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION: Effective analgesia is an integral part of postoperative management in surgical patients. The analgesic requirement of patients following laparotomy surgeries could not be met by single method. Epidural analgesia is the most widely used method of analgesia in intra – and postoperative period with a higher success rate. But in patients who are on anticoagulants or patients with anatomical spine distortion the use of epidural catheter to provide continuous analgesia is either impossible or contraindicated. A modified rectus sheath block with catheter placement in the posterior rectus sheath allows continuous infusion of local anaesthetic in the post operative period. AIM OF THE STUDY: To compare the post-operative analgesic efficacy of continuous rectus sheath catheter infiltration and continuous wound catheter infiltration. METHODOLOGY: This is a Randomised Controlled Trial on 60 Patients belonging to ASA PS I & II posted for laparotomy surgeries were randomised into two groups. Group CWC – Continuous Wound catheter infusion with 0.25% Inj. Bupivacaine 2 ml/hr bilaterally. Group RSC – Rectus Sheath Catheter placed under USG guidance and continuous infusion of 0.25%Inj. Bupivacaine 2 ml/hrbilaterally. Post operative hemodynamics, VAS score at rest and opioid consumption were assessed at 0 hr, 6 hr, 12 hr, 24 hr, 36 hr and 48 hr. The results were analysed. RESULTS: The post-operative mean VAS score at rest was less in RSC group (1.67 – 2.2) than in CWC group (3.6 – 4.1). The opioid consumption was more in CWC group (26.7% vs 6.7 %) than in RSC group. Further, RSC group has more hemodynamic stability. CONCLUSION: From the study conducted in postoperative patients, it is concluded that the analgesic efficacy of Rectus sheath catheter infusion is better than continuous wound catheter infusion and the postoperative opioid consumption can be decreased with Rectus sheath catheter infusion of Local Anaesthetics in Laparotomy surgeries.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Rectus Sheath catheter, Wound Catheter, Bupivacaine, Post operative analgesia, VAS, Opioid.
Subjects: MEDICAL > Anaesthesiology
Depositing User: Subramani R
Date Deposited: 19 Aug 2019 01:08
Last Modified: 19 Aug 2019 01:08

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