Epidural Catheter and Surgically Implanted Rectus Sheath Catheter in Management of Postoperative Pain

Study Overview
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Brief Summary
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One hundred and twenty patients at age range from 18 to 60 undergoing laparotomy was enrolled in this study. Patients were randomly assigned to two groups 60 in epidural group and the other 60 patients in rectus catheter group. epidural catheter inserted pre induction but rectus sheath catheter inserted by the surgeon at the end of surgery.

Detailed Description
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One hundred and twenty patients at age range from 18 to 60 undergoing laparotomy was enrolled in this study. Patients were randomly assigned to two groups 60 in epidural group and the other 60 patients in rectus catheter group. epidural catheter inserted pre induction but rectus sheath catheter inserted by the surgeon at the end of surgery. In both groups we activated with10 ml bupivacain25% before patient recovery then 10 ml bupivacain.125% each 6 hours. If patient still in pain 1gm perflgan injected. If patient still in pain 10 mg nalufine for 70 kg patient injected. we will record pulse, blood pressure and visual analogue scale at 0,6,12,24 and 36 hours postoperative. Also Occurrence of nausea and vomiting, Time of return of bowel movement, Time of discharage and amount of analgesia used will be recorded. Results, discution will be later.

Official Title
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Comparison Between Epidural Catheter and Surgically Implanted Rectus Sheath Catheter in Management of Postoperative Pain Following Laparotomy

Conditions
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Postoperative Pain

Intervention / Treatment
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* Device: Epidural catheter
* Device: rectus sheath catheter


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients at age rang from 18 to 60 undergoing laparotomy patients ASA1,2 physical status Exclusion Criteria: any known coagulopathy morbid obesity kyphosis or scoliosis those with known sensitivity to local anesthetic drugs lack of cooperation and inability to understand or perform verbal or physical assessments.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Epidural Group<br>epidural catheter inserted pre induction | Device: Epidural catheter<br>* epidural catheter inserted pre induction<br>|
| Active Comparator: Rectus sheath catheter Group<br>rectus sheath catheter inserted by the surgeon at the end of surgery | Device: rectus sheath catheter<br>* The surgeon will place one hand inside the abdomen and with the other hand inserted the Tuohy needle through the skin and fascia. The surgeon will feel when the needle tip is just superfacial to interface between the peritoneum and muscle layer and avoid penetration of inferior epigastric artery. The procedure will be repeated on the contralateral<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative pain relief | Measured by Visual Analogue Scale (VAS) pain measurement scale divided from 0 to 10 where 0 is no pain and10 worst pain can be imagined | 36hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Side effects | Occurrence any side effects Time of return of bowel movement. Time of discharage. Amount of analgesia used | 36hours | 
| Total of analgesic consumption | total consumption of naluphine and paracetamol pre milligram | 36 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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rectus sheath catheter, pain following laparotomys.