RCT - Epidural vs. wound catheter following liver resection
Research type
Research Study
Full title
An RCT comparing Epidural versus continuous Local Anaesthetic infiltration with wound catheters and PCA after open liver resection
IRAS ID
143673
Contact name
Ernest Hidalgo
Contact email
Sponsor organisation
Leeds Teaching Hospitals NHS Trust
Duration of Study in the UK
1 years, 6 months, 1 days
Research summary
Good pain control after surgery allows early mobilization, reduces post-operative complications and minimises patient distress. The gold standard (best) in abdominal surgery is currently thought to be epidural analgesia (continuous infiltration of local anaesthesia into the epidural space blocking pain signals from the spinal nerves).
An alternative to epidural is patient controlled analgesia (PCA). Although epidural analgesia has been shown to provide superior analgesia when compared with PCA, they can cause significant side effects such as lowering blood pressure and causing haematomas (blood clots) or abscesses (collection of pus) in the epidural space. In addition, there is a 20-30% failure rate.
When using PCA, one method aimed at reducing the need for IV opiates is the placement of indwelling wound catheters (plastic tubes inserted into the tissues near the wound) that continually infuse local anaesthetic around the wound to block abdominal wall nerves. This technique has been shown to be effective after abdominal surgery and liver resection in several studies and reduce PCA use.
Current evidence looking at wound catheters in liver surgery suggests that pain control with epidural and wound catheters +/- PCA is comparable. We hypothesize that wound catheter use will allow enhanced recovery and ultimately a shorter length of stay based on 1. adeqaute pain control and 2. lack of side effects.
This study aims to compare postoperative recovery between patients with epidural analgesia versus the combination of continuous infiltration of local anaesthetic with wound catheters and IV PCA with opiate analgesia following open liver resection.
We expect that pain control will be similar between the two groups and that we will see a shorter days from surgery to be medically fit for discharge in the wound catheter group.REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
14/YH/1267
Date of REC Opinion
5 Dec 2014
REC opinion
Further Information Favourable Opinion