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    Use of rectus sheath catheters for pain relief in patients undergoing major pelvic urological surgery

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    URI
    http://hdl.handle.net/11287/593788
    Author
    Dutton, Thomas J.
    McGrath, John S
    Daugherty, Mark O.
    Date
    2014-02-01
    Journal
    BJU international
    Type
    Journal Article
    Evaluation Studies
    Publisher
    Wiley
    DOI
    10.1111/bju.12316
    Metadata
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    Abstract
    OBJECTIVE: To report on the safety and efficacy of rectus sheath blocks, 'topped-up' using bilateral rectus sheath catheters (RSCs), in patients undergoing major open urological surgery. METHODS: The RSCs were inserted under ultrasound guidance into 200 patients between April 2008 and August 2011, of whom 106 patients underwent radical retropubic prostatectomy (RRP) and 94 underwent open radical cystectomy (ORC). A retrospective case-note review was undertaken. Outcomes included technical success and complication rates of the insertion and use of RSC, visual analogue pain scores, additional analgesia requirements and length of hospital stay (LOS). RESULTS: All RSCs were successfully placed without complication and used for a mean of 3.6 days for ORC and 2.1 days for RRP. Early removal occurred in 6.49% of patients. Low overall pain scores were reported in both groups. Patients were more likely to require a patient-controlled analgesia system in the ORC group but the overall need for additional analgesia was low in both groups, reducing significantly after the initial 24 h. In combination with an enhanced recovery programme, LOS reduced from 17.0 to 10.8 days in the ORC group and from 6.2 to 2.8 days in the RRP group. CONCLUSION: The use of RSCs appears to offer an effective and safe method of peri-operative analgesia in patients undergoing major open urological pelvic surgery.
    Citation
    BJU Int. 2014 Feb;113(2):246-53.
    Publisher URL
    http://dx.doi.org/10.1111/bju.12316
    Note
    This article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.
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    • 2014 RD&E publications
    • HeSRU publications
    • Urology

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