Rectus sheath catheter insertion technique
Research type
Research Study
Full title
Clinical trial comparing effect of bolus local anaesthetic injection versus no bolus injection prior to insertion of interfascial rectus sheath catheter for reducing damage to catheter on insertion after midline laparotomy
IRAS ID
252779
Contact name
Angus Macdonald
Contact email
Sponsor organisation
NHS Lanarkshire
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
This study aims to explore whether the injection of local anaesthetic prior to intraoperative placement of a interfascial rectus sheath catheter reduces the amount of damage the catheter sustains on insertion by separating the planes in which the catheter is placed. A lot of research has been invested in exploring the effectiveness of rectus sheath catheters as an alternative/complimentary method to spinal anaesthesia for pain relief after laparotomy with varying results. There has also been research into how the catheter is placed: ultrasound guided versus intra-operative surgical insertion under direct vision and prefascial/subcutaneous versus interfascial placement. However, no research exists exploring whether bolus injection of local anaesthetic reduces damage to the rectus sheath catheter by opening up the prefascial plane. This randomised clinical trial will be conducted at University Hospital Monklands in the General Surgery department. Strict inclusion/exclusion criteria will recruit appropriate patients attending for elective laparotomy procedures. Two methods of rectus sheath catheter placement will be analysed; a) placement with preceeding local anaesthetic into interfascial space and b) placement without preceeding local anaesthetic. To reduce bias each participant will act as their own control and have the two rectus sheath catheters placed using both techniques which this study is analysing. Each patient will undergo randomisation to determine which side will have the local anaesthetic injected into interfascial space prior to the placement of the rectus sheath catheter. Both rectus sheath catheters will provide continuous infusion of local anaesthetic at specifiec dose for a specified time. The catheters will then be removed and the number of kinks in each catheter counted.
REC name
South West - Cornwall & Plymouth Research Ethics Committee
REC reference
19/SW/0127
Date of REC Opinion
19 Jul 2019
REC opinion
Favourable Opinion