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The purpose of this study is to find out whether the use of Painbuster® (a local anaesthetic wound catheter) can be used instead of epidurals for patients having bowel surgery in an enhanced recovery programme. The investigators want to find out whether or not using this device means people need to stay in hospital for less time after surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Epidural | Active Comparator | Subjects will have an epidural catheter placed to provide postoperative pain relief. This is standard care for those undergoing an enhanced recovery program. |
|
| Painbuster | Active Comparator | Subjects will have a local anaesthetic wound catheter inserted into the wound at time of surgery rather than an epidural for the provision of postoperative pain relief. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Epidural | Other | Epidural analgesia inserted prior to surgery to stay in until at least the second postoperative day |
|
| Measure | Description | Time Frame |
|---|---|---|
| Length of hospital stay | Length of stay will be measured in days for each group.This will be determined by a set of predefined discharge criteria. | determined on discharge from hospital |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative complications | All complications in the postoperative period will be recorded. Particular emphasis will be given to:
|
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Eleanor R Richards, BM Medicine | Contact | 0044723368111 | 5324 | errichards@doctors.org.uk |
| Name | Affiliation | Role |
|---|---|---|
| Eleanor R Richards, BM Medicine | Scarborough General Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Scarborough General Hospital | Recruiting | Scarborough | North Yorkshire | YO126QL | United Kingdom |
| Type | Date | Date Unknown |
|---|---|---|
| Release | Oct 17, 2016 | |
| Reset | Dec 9, 2016 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Oct 17, 2016 | Dec 9, 2016 |
| ID | Term |
|---|---|
| D010146 | Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D007268 | Injections, Epidural |
| ID | Term |
|---|---|
| D007278 | Injections, Spinal |
| D007267 | Injections |
| D004333 | Drug Administration Routes |
| D004358 | Drug Therapy |
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| Local anaesthetic wound catheter | Other | The catheter will be used to infuse the wound with local anaesthetic for 48 hours post op. |
|
|
| Whilst an inpatient |
| Episodes of hypotension in the postoperative period | This will be defined as a systolic blood pressure of less than 90 mmHg | whilst an inpatient |
| Postoperative pain | This will be assessed objectively using the visual analogue scale for pain. Measurements will be taken twice a day for as long as the epidural catheter or Painbuster® is in situ. Pain scores will be measured at rest and on coughing. | as an inpatient |
| Amount of postoperative IV fluid administered | This will be documented on each postoperative day. | as an inpatient |
| Body composition | Body composition (Fat Mass, Fat Free Mass, Extracellular Fluid Volume, Intracellular Fluid Volume, and Total Body Water) will be determined using a bioelectrical impedence analysis (BIA) machine, specifically the "Bodystat" machine. | Tests will be performed daily until the epidural or Painbuster® has been removed. |
| Postoperative analgesic requirement | The total quantity and type (opiate or non-opiate) of all analgesics administered during the period when epidurals or Painbuster® was in situ will be recorded. | As an inpatient |
| Postoperative stress response | This will be assessed using: SIRS criteria C reactive protein Indirect calorimetry on alternate days at a fixed time. | As an inpatient |
| Anaesthetic time required | he time taken in minutes for insertion of epidural or wound catheter will be recorded in each group. | On the day of operation |
| Postoperative mobility | Postoperative mobility will be assessed as time until sit to stand aided and unaided, duration of time spent out of bed on each postoperative day and maximum walking distance with assistance on a daily basis. In addition, assessment of mobilisation will be carried out by the physiotherapists who will record this in patient notes. All patients will be given pedometer to wear which will count the number of steps taken. Pedometer readings will be taken twice a day. Pedometers have been previously validated as an objective measurement of mobility. | as an inpatient |
| Day of return of gut function | Return of gut function will be defined by the tolerance of >/= 80% of the prescribed nutritional requirement. This will be assessed by a dietician. | As an inpatient |
| D013812 |
| Therapeutics |