Open Liver Resection
Conditions
Keywords
epidurals, wound catheters, liver resection, liver surgery
Brief summary
The investigators plan to compare epidurals versus wound catheters for effects on pain relief and recovery following open liver surgery.
Interventions
DEVICEWound catheter
Wound catheter, placed at end of procedure, prior to closure. To be kept in for 48 hours.
DEVICEEpidural
Sponsors
NHS Lothian
University of Edinburgh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients undergoing open hepatic resection for benign or malignant conditions.
Exclusion criteria
* Patients with contraindication to either epidural or wound catheter techniques. * Inability to give written, informed consent. * Jaundice (Bilirubin \> 100 μmol/L) * Liver resection combined with secondary surgical procedure. * Age \< 18 years * Pregnant women * patients on long term opiates for chronic pain
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Length of stay | Measurement made on day of discharge which is expected to be on average bewteen 5 and 10 days after surgery. | Number of days (to nearest half day) patients stay in hospital. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Molecular response to surgery | Days 0, 1 and 3 | HMGB1, RAGE and cytokines |
| Pain Scores | Performed daily at 0900 hours. On the day of surgery pain scores will be performed at 2, 6 and 12 hours post surgery. | Visual analogue scores of pain experienced. |
| Central Venous Pressure | During liver transection | Mean Central Venous Pressure during liver transection will be quantified and compared between groups. |
| Estimated Blood Loss | Intra-operative | — |
| Operative field asessment | During liver transection | — |
| Pringle time | Intra-operative | — |
Other
| Measure | Time frame |
|---|---|
| IV Fluid volume | Day of Surgery and postoperative days 1-7 |
| Complications | day of surgery and post-operative days 1-30 |
| Post-operative blood tests (FBC, U&E, LFTs, coag) | Post-operative days 1-7 |
| Morphine consumption | Day of surgery and postoperative days 1-7 |
| Quality of Life (EQ-5D) | Pre-operative, 2 weeks post-operative, 4-6 weeks post-operative |
Countries
United Kingdom
Outcome results
None listed