Rectus sheath pain control after major abdomino-pelvic surgery

ISRCTN ISRCTN77620476
DOI https://doi.org/10.1186/ISRCTN77620476
Secondary identifying numbers N/A
Submission date
16/02/2012
Registration date
26/03/2012
Last edited
14/06/2017
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Most patients undergoing abdominal surgery have an epidural catheter inserted – this is a small plastic tube placed into the back at the start of the operation which allows the anaesthetist to give local anaesthetic to numb the nerves coming from the spinal cord. A different method that has been used more recently involves placing small tubes just under the muscles in the front of the abdomen, called a ‘rectus sheath catheter’. This also allows local anaesthetic to be given down the catheters after the operation, thereby keeping the patient comfortable. The aim of our study is to test whether one of these techniques is better than the other, not just in terms of pain relief but also the safety of the procedures, the ability for patients to move around after the operation, as well as the amount of care that needs to be provided by the doctors or nurses during the patient's recovery.

Who can participate?
Male or female patients aged 18 or over undergoing major abdomino-pelvic surgery.

What does the study involve?
Participants will be randomly allocated into one of two groups. One group will have an epidural catheter placed for pain relief and the other group will have rectus sheath catheters. We will then study the differences between the two anaesthetic techniques. We will collect information from clinical notes and routine measurements on the ward such as blood pressure, pulse and temperature. We will also assess how mobile the participant is following the operation and how much time is required from the doctors and nurses to look after the anaesthetic catheters.

What are the possible benefits and risks of participating?
We are studying this because there are potential benefits as well as disadvantages with both procedures and we would therefore like to look in a scientific manner to see whether one technique has a significant advantage over the other. We will use the results from this study to design a much larger study that will run in several hospitals in the UK. Our results will be published in the international medical literature so that other clinicians can see the findings. If the findings show an improved level of care for one technique compared to the other, we will encourage the use of the technique in other hospitals. For participants, there are no additional risks over and above the normal clinical care. Both anaesthetic techniques are currently in use in the Royal Devon and Exeter NHS Foundation Trust. The procedures themselves obviously have potential risks which would be explained routinely to both study patients and patients having routine clinical care ahead of any surgery.

Where is the study run from?
Exeter Surgical Health Services Research Unit (UK).

When is the study starting and how long is it expected to run for?
From February to June 2012.

Who is funding the study?
The Research and Development Unit at the Royal Devon & Exeter NHS Foundation Trust (UK).

Who is the main contact?
Mr John McGrath (01392 406277)
Mr Thomas Dutton (01392 408940, thomas.dutton@rdeft.nhs.uk)

Contact information

Mr John McGrath
Scientific

Exeter Surgical Health Services Research Unit
Royal Devon and Exeter NHS Foundation Trust
Exeter
EX2 5DW
United Kingdom

Study information

Study designSingle-centre pilot randomised control trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleRectus Sheath Catheters in Major Abdomino-Pelvic Surgery: a pilot randomised controlled trial
Study acronymRSC-iMAPS
Study objectivesAnalgesia delivered by rectus sheath catheters is equivalent with respect to efficacy and safety when compared to epidural-based analgesia for patients undergoing major abdomino-pelvic surgery.
Ethics approval(s)NRES Committee South West, Cornwall and Plymouth, 07/11/2011, ref: 11/SW/0274
Health condition(s) or problem(s) studiedPelvic cancer
InterventionEpidural catheter versus rectus sheath catheter-based analgesia
Intervention typeProcedure/Surgery
Primary outcome measureIs rectus sheath catheter based analgesia equivalent to epidural based analgesia in patients undergoing major abdomino-pelvic surgery in terms of safety and efficacy?
Safety is assessed by recording the number of adverse events and complications associated with the trial. Efficacy is assessed by a number of means: patient pain scores, time to mobilisation, time to flatus, time to bowel opening, and readmission rate. The measurements are taken for the duration of the in-patient stay, and then up to 31 days post-operatively to record the readmission rate during this period.
Secondary outcome measures1. Procedural time
2. Total blood loss/transfusion
3. Hypotensive episodes
4. Urine output
5. Total intravenous fluids administered
6. Patient mobilisation
7. Opiate avoidane
8. Gastro-intestinal morbidity
9. Respiratory morbidity
10. Demands on nursing/medical care
11. Cost-effectiveness
12. Patient length of stay
13. Patient acceptability
The measurements are taken for the duration of the in-patient stay, and then up to 31 days post-operatively to record the readmission rate during this period
Overall study start date15/02/2012
Completion date30/06/2012

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants88
Key inclusion criteria1. Diagnosed with a surgical/medical condition requiring a midline laparotomy and exenterative procedure
2. Willing and able to provide informed consent for participation in the study
3. Male or female aged 18 years or over
Key exclusion criteria1. Refusal to participate in the trial/provide informed consent
2. Unable to provide informed consent
3. Inappropriate surgical approach, e.g. laparoscopic
4. Contra-indications to an epidural catheter or rectus sheath catheter
Date of first enrolment15/02/2012
Date of final enrolment30/06/2012

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Exeter Surgical Health Services Research Unit
Exeter
EX2 5DW
United Kingdom

Sponsor information

Royal Devon and Exeter NHS Foundation Trust (UK)
Hospital/treatment centre

Royal Devon and Exeter Hospital
Barrack Road
Exeter
EX2 5DW
England
United Kingdom

Website http://www.rdehospital.nhs.uk/
ROR logo "ROR" https://ror.org/03085z545

Funders

Funder type

Hospital/treatment centre

Royal Devon and Exeter Healthcare Trust (UK) - Small Grants Award 2010 ref: 20101207JM

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Editorial Notes

14/06/2017: No publications found, verifying study status with principal investigator