CAMELOT - Continuous rectus sheath Analgesia in eMErgency LaparOTomy
Research type
Research Study
Full title
CAMELOT - Continuous rectus sheath Analgesia in eMErgency LaparOTomy. Multi-centre, randomised sham-controlled trial of rectus sheath catheter-delivered local anaesthetic infusion compared with usual care in patients undergoing emergency bowel surgery.
IRAS ID
312553
Contact name
Mark Edwards
Contact email
Sponsor organisation
University Hospital Southampton NHS Foundation Trust
ISRCTN Number
ISRCTN15475290
Duration of Study in the UK
4 years, 1 months, 31 days
Research summary
In the UK around 30,000 patients, a year undergo an operation called an emergency laparotomy to treat life-threatening conditions. A large vertical cut is made in the abdomen when patients are asleep under general anesthesia. Good pain relief after surgery will help patients feel better and recover quicker. Because of the high level of pain experienced by many patients, opioid-based painkillers such as morphine are often given, using patient-controlled analgesia (PCA) pumps. However, morphine can cause serious side effects such as breathing problems, nausea and vomiting, and delayed bowel movement, which can slow patient recovery. Rectus sheath catheters (RSCs) are a newer way of providing pain relief, where two thin tubes (catheters) are inserted on either side of the wound during the operation. Local anesthetic is injected slowly into the catheters to numb the nerves and reduce pain for about three days. Small studies suggest that RSCs may provide effective pain relief, reduce the use of morphine, and help patient recovery. Potential disadvantages are that RSCs take time to insert and are expensive. More work is needed to understand whether there are any unwanted effects with RSCs.
Our study will find out whether adding a RSCs to standard patient-controlled analgesia provides better pain relief, fewer side effects and complications, and greater satisfaction for patients undergoing emergency laparotomy compared to a control group who will receive a sham catheter with no infusion of analgesia. Our study will also aim to determine whether RSCs are safe and cost-effective.
REC name
London - Bromley Research Ethics Committee
REC reference
22/LO/0555
Date of REC Opinion
24 Aug 2022
REC opinion
Favourable Opinion