TERSC (version 1.0)
Research type
Research Study
Full title
A randomised controlled trial of thoracic epidural analgesia versus rectus sheath catheters for open midline incisions in major abdominal surgery within an Enhanced Recovery Program.
IRAS ID
61767
Contact name
Anton Krige
Contact email
Sponsor organisation
East Lancashire Hopsital NHS Trust
Research summary
After major abdominal surgery good pain relief is very important to recover quickly and avoid complications. At the moment the most common way of doing this in the UK is with an epidural. This is a fine catheter (tube) placed in the spine through which local anaesthetic is given, numbing the nerve supply to the abdomen and controlling the pain. Epidurals can be very effective but they do have a number of possible side effects including headaches and low blood pressure (common), and nerve injury (very rare).
Rectus Sheath Catheters (RSCs) are another method of pain control which can be used when surgery involves a midline (vertical) incision. In this technique, local anaesthetic is infused directly into the abdominal wall, blocking the nerves around the wound site. An old technique, RSCs are now in use again as ultrasound allows doctors to site the catheters accurately between the muscle layers of the abdomen. Many of the side effects associated with epidurals do not apply to rectus sheath catheters and this may confer an advantage. However, no formal research has yet been conducted and so it is not known for sure which technique results in the best pain relief with the least side effects.
This is the question that TERSC aims to answer. Patients taking part will be randomly allocated to receive either an epidural or RSCs after surgery. Information on pain relief, bowel function, side effects, complications, recovery and length of hospital stay (amongst other things) will then be collected by researchers and used for comparison. Some patients will also be interviewed after discharge, looking in more detail at their overall experience of hospital.REC name
North West - Greater Manchester East Research Ethics Committee
REC reference
13/NW/0782
Date of REC Opinion
21 Nov 2013
REC opinion
Favourable Opinion