Topic: National Cancer Research Network, Generic Health Relevance and Cross Cutting Themes
Conditions
Interventions
Potentially eligible patients will be identified by their treating surgical team. If willing to discuss the trial further, their details will be passed on to researchers and written and verbal explan
Sponsors
East Lancashire Hospitals NHS Trust (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Patients over 18 years of age 2. Planned elective major abdominal surgery including major colorectal resections, upper GI surgery (e.g. pancreaticoduodectomy) and major urological surgery (e.g. radical cystectomy) 3. Planned open midline surgical incision 4. Included in the ERP 5. Willing and able to give consent 6. American Society of Anesthesiologists (ASA) score 13
Exclusion criteria
Exclusion criteria: 1. Contraindication to epidural analgesia (e.g. coagulopathy, local infection, systemic sepsis, severe aortic stenosis) 2. Consent refused for either thoracic epidural analgesia (TEA) or Rectus Sheath Catheters (RSCs) 3. Non-English speaker 4. Ano-rectal excision (e.g. pan-proctocolectomy or AP resection) 5. Planned transverse or oblique incisional approach 6. Allergy to local anaesthetic drugs or opiates 7. Opiate tolerance 8. Pre-existing chronic abdominal pain 9. Extensive existing midline abdominal scarring
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. VAS pain scores at rest and movement (from supine to sitting position) at 2, 6, 12, 24, 48 and 72 hours after wound closure 2. Patient experience | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Functional pain scores and opiate consumption 2. Recovery profile i.e. time to return of GIT function, time until surgically fit for hospital discharge and actual LOS 3. Morbidity including fluid balance, incidence of hypotension and Day 5 POMS score 4. Cost effectiveness and postoperative recovery scores | — |
Countries
United Kingdom
Outcome results
None listed