Intraperitoneal Local Anaesthetic in Colonic Surgery
Status:
Completed
Trial end date:
2010-01-01
Target enrollment:
Participant gender:
Summary
Aim:
The general aim of this research group is to improve the recovery of patients after abdominal
surgery. The specific aim of this study is to conduct a randomized, double blinded,
controlled trial to investigate the effect of intra-peritoneal local anaesthesia application
on postoperative pain and post-operative fatigue. This will be conducted in the setting of an
enhanced recovery after surgery program (ERAS).
Methods:
Patients will be randomised by computer generated random numbers and opaque envelope method.
In the treatment arm patients will receive 10ml 0.75% ropivacaine diluted to 50mls with 0.9%
saline soon after the creation of the laparotomy . In the placebo arm, 50mls of 0.9% normal
saline will be used in a similar fashion. At closure, two small 2mm catheter belonging to the
On-Q pain buster system will be placed in the peritoneal cavity. This will be attached to a
pump which will contain either a 0.2% ropivacaine solution or 0.9% saline placebo running at
4mls/hr for 68 hours. All members involved in patient care (with the exception of one nurse)
will be blinded to the above. After 68 hours the pump will be stopped and the catheter will
be removed. Assessment of postoperative pain will be performed by visual analogue scale, and
fatigue assessment will be done using the Identity Consequence Fatigue Scale (ICFS) at
various intervals post-operatively. Blood tests for inflammatory markers including glucose,
cortisol, CRP, albumin and several cytokines as well as local anaesthetic levels will be
taken.
Significance to health:
This method of analgesia administration has not been investigated in open major colonic
surgery. This trial has wide reaching implications, with the potential to improve pain and
thus recovery after abdominal surgery.