Continuous Local Anaesthetic Wound Infiltration in Hepatobiliary Surgery - A Comparison with Placebo

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The aim of this project is to see whether continuous local anaesthetic wound infiltration for 48 hours post-operatively is useful in hepatobiliary surgical procedures in terms of: 1. Better pain relief 2. Reduced opiate consumption via patient-controlled analgesia (PCA) regime 3. Reduced opiate side effects (eg. nausea and vomiting, sedation, itch) All patients enrolled would have a continuous wound infiltration catheter with a local anaesthetic pump device attached, as well as an opioid-continaing PCA machine. The contents of this pump device would be randomised to contain either local anaesthetic agent or normal saline (placebo). The wound infiltration catheter and infusion pump would remain for 48 hours post-operatively, and the PCA would remain available to each patient as long as clinically required. Each patient would be reviewed post-operatively as per our normal Acute Pain Service (APS) practice, and each patient would have regular observations performed and recorded as per normal protocol. The data collected from each patient would include total opioid requirement via PCA, visual analogue scale (VAS) pain scores both at rest and with movement, and any side effects possibly related to local anaesthetic agents or infusion pump catheters.

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