Postoperative analgesia of ultrasound guided rectus sheath catheters versus continuous wound catheters for colorectal surgery: A randomized clinical trial

Dowidar, Abd El Raheem Mostafa; Ezz, Hoda Alsaid Ahmed; Shama, Ahmed A; El-Oraby, Marwa Ahmed

doi:10.1016/j.egja.2016.02.001

Cited by 6 publications

(6 citation statements)

References 24 publications

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“…One RCT. 8 investigated the effect of bilateral rectus sheath block compared with continuous wound infiltration. Basic analgesia was not given and no difference between either modality was observed.…”

Section: Resultsmentioning

confidence: 99%

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Pain management after open colorectal surgery

Uten,

Chesnais,

van de Velde

et al. 2024

European Journal of Anaesthesiology

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BACKGROUND Open colectomy is still performed around the world and associated with significant postoperative pain.OBJECTIVES Unpublished recommendations based on a systematic review were proposed by the PROcedure SPE-Cific postoperative pain managemenT (PROSPECT) group in 2016. We aimed to update these recommendations by evaluating the available literature and develop recommendations for optimal pain management after open colectomy according to the PROSPECT methodology.DESIGN AND DATA SOURCES A systematic review using the PROSPECT methodology was undertaken. Randomised controlled trials and systematic reviews published in the English language from 2016 to 2022 assessing postoperative pain after open colectomy using analgesic, anaesthetic or surgical interventions were identified. The primary outcome included postoperative pain scores. RESULTSThe previous 2016 review included data from 93 studies. Out of 842 additional eligible studies identified, 13 new studies were finally retrieved for analysis. Intra-operative and postoperative interventions that improved postoperative pain were paracetamol, epidural analgesia. When epidural is not feasible, intravenous lidocaine or bilateral TAP block or postoperative continuous pre-peritoneal infusion are recommended. Intra-operative and postoperative Cyclo-oxygenase (COX)-2 specific-inhibitors or non-steroidal anti-inflammatory drugs (NSAIDs) are recommended for colonic surgery.CONCLUSIONS The analgesic regimen for open colectomy should include intra-operative paracetamol and COX-2 specific inhibitors or NSAIDs (restricted to colonic surgery), epidural and continued postoperatively with opioids used as rescue analgesics. If epidural is not feasible, bilateral TAP block or IV lidocaine are recommended. Safety issues should be highlighted: local anaesthetics should not be administered by two different routes at the same time. Because of the risk of toxicity, careful dosing and monitoring are necessary.

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Section: Resultsmentioning

confidence: 99%

“…Qazi et al 7 also reported reduced postoperative opioid consumption with TAP block. One RCT 8 . investigated the effect of bilateral rectus sheath block compared with continuous wound infiltration.…”

Section: Resultsmentioning

confidence: 99%

Pain management after open colorectal surgery

Uten,

Chesnais,

van de Velde

et al. 2024

European Journal of Anaesthesiology

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“…Internal organ injury 0 (0%) 0 (0%) -Systemic toxicity 0 (0%) 0 (0%) -G general anaesthesia; GR Bilateral rectus sheath block combined with general anaesthesia plane of the transverse abdominis muscle, entered the rectus abdominis sheath, and distributed on the surface of the skin [18]. The main process of RSB is to inject local anaesthetics between the rectus abdominis and the posterior sheath of the rectus abdominis [19]. Therefore, RSB exerted a good effect in terms of perioperative analgesia for median abdominal incisions [20].…”

Section: Discussionmentioning

confidence: 99%

The impact of ultrasound-guided bilateral rectus sheath block in patients undergoing cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy — a retrospective study

et al. 2020

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Background: Rectus sheath block (RSB) is known to attenuate postoperative pain and reduce perioperative opioid consumption. Thus, a retrospective study was performed to examine the effects of bilateral rectus sheath block (BRSB) in cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC). Methods: A total of 178 patients undergoing CRS/HIPEC at our hospital were included. Patient information and anaesthesia-related indicators were collected from the electronic medical record (EMR) system. All subjects were divided into the following two groups: the G group (general anaesthesia) and the GR group (RSB combined with general anaesthesia). Patients in the GR group received 0.375% ropivacaine for BRSB before surgery. The primary outcomes included the total amount of remifentanil and rocuronium, the total consumption of dezocine after surgery, the visual analogue scale (VAS) score and the patient-controlled intravenous analgesia (PCIA) input dose at 1 h (T6), 6 h (T7), 12 h (T8), 24 h (T9) and 48 h (T10) after surgery. Other outcomes were also recorded, such as patient demographic data, the intraoperative heart rate (HR) and mean arterial pressure (MAP), and postoperative complications. Results: Compared with the G group, the GR group showed a shorter time to tracheal extubation (P < 0.05), a decreased total amount of remifentanil and rocuronium (P < 0.05), and a reduced VAS score, PCIA input dose and number of PCIA boluses at 1 h, 6 h and 12 h after surgery (P < 0.05). However, at 24 h and 48 h after surgery, there were no differences in the VAS score of pain at rest or during motion between the two groups (P > 0.05). Moreover, the incidence of hypertension, emergence agitation, delayed recovery, hypercapnia, and nausea and vomiting was lower in the GR group than in the G group (P < 0.05). There were no differences in the changes in MAP and HR during the surgery between the two groups (P > 0.05). No complications associated with nerve block occurred. Conclusion: BRSB could provide short-term postoperative analgesia, reduce perioperative opioid consumption and reduce the incidence of postoperative complications. It is an effective and safe procedure in CRS/HIPEC.

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“…Bashandy reported that anterior branches of the T7-T12 thoracic nerve and the L1 lumbar nerve travelled through the plane of the transverse abdominis muscle, entered the rectus abdominis sheath, and distributed on the surface of the skin [18]. The main process of RSB is to inject local anaesthetics between the rectus abdominis and the posterior sheath of the rectus abdominis [19].…”

Section: Discussionmentioning

confidence: 99%

The impact of ultrasound-guided bilateral rectus sheath block in patients undergoing cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy — a retrospective study

Wang

Liu

Gao

et al. 2020

Preprint

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Background : Rectus sheath block (RSB) is known to attenuate postoperative pain and reduce perioperative opioid consumption. Thus, a retrospective study was performed to examine the effects of bilateral rectus sheath block (BRSB) in cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC). Methods : A total of 178 patients undergoing CRS/HIPEC at our hospital were included. Patient information and anaesthesia-related indicators were collected from the electronic medical record (EMR) system. All subjects were divided into the following two groups: the G group (general anaesthesia) and the GR group (RSB combined with general anaesthesia). Patients in the GR group received 0.375% ropivacaine for BRSB before surgery. The primary outcomes included the total amount of remifentanil and rocuronium, the total consumption of dezocine after surgery, the visual analogue scale (VAS) score and the patient-controlled intravenous analgesia (PCIA) input dose at 1 h (T6), 6 h (T7), 12 h (T8), 24 h (T9) and 48 h (T10) after surgery. Other outcomes were also recorded, such as patient demographic data, the intraoperative heart rate (HR) and mean arterial pressure (MAP), and postoperative complications. Results : Compared with the G group, the GR group showed a shorter time to tracheal catheter extraction (P<0.05), a decreased total amount of remifentanil and rocuronium (P<0.05), and a reduced VAS score, PCIA input dose and number of PCIA boluses at 1 h, 6 h and 12 h after surgery (P<0.05). However, at 24 h and 48 h after surgery, there were no differences in the VAS score of pain at rest or during motion between the two groups (P>0.05). Moreover, the incidence of hypertension, emergence agitation, delayed recovery, hypercapnia, and nausea and vomiting was lower in the GR group than in the G group (P<0.05). There were no differences in the changes in MAP and HR during the surgery between the two groups (P>0.05). No complications associated with nerve block occurred. Conclusion : BRSB could provide short-term postoperative analgesia, reduce perioperative opioid consumption and reduce the incidence of postoperative complications. It is an effective and safe procedure in CRS/HIPEC.

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Postoperative analgesia of ultrasound guided rectus sheath catheters versus continuous wound catheters for colorectal surgery: A randomized clinical trial

Cited by 6 publications

References 24 publications

Pain management after open colorectal surgery

Pain management after open colorectal surgery

The impact of ultrasound-guided bilateral rectus sheath block in patients undergoing cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy — a retrospective study

The impact of ultrasound-guided bilateral rectus sheath block in patients undergoing cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy — a retrospective study

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