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575 Rectus sheath catheters versus epidural analgesia for open midline incisions in major gynaecological- oncology surgery
  1. D Kaludova,
  2. A Rechner,
  3. F Correia Martins and
  4. P Pathiraja
  1. Addenbrooke’s Hospital, UK


Introduction/Background*Rectus sheath catheters (RSCs) have frequently been used in several surgical specialities. The aim of the project was to compare the efficacy of RSCs and epidural analgesia (EA) in the post op period in patients who underwent major Gynae-Oncology surgery requiring midline incisions in terms of time to discharge, time to removal of urinary catheter (TWOC), patient experience.

Methodology We retrospectively analyzed two main groups of patients- patients who had RSCs and patients who had EA as a primary mode of post-operative analgesia (PMPOA). We used ChiSquare and Students T.test to compare the group variables for statistical significance.

Result(s)*A total of 39 patients were identified- 20 with RSCs and 19 with EA. The two groups of patients were commenced on post-op PCA in addition to the PMOPA. All patients with RSCs had PCA. 8 out of 19 patients with EA did not have PCA. Within each group patients were on variable PCA types with the most used Fentanyl and Morphine. There was no significant difference on types of PCA used (p=0.054) and ASA (p=0.341). Perception of postoperative pain was not significantly different between RSC and EA groups. In the RSC group there was a significantly shorter post-operative time between surgery and TWOC (p=0.0036) and between surgery and discharge when compared with the EA group (p=0.0051).

Conclusion*Our data shows that patients who had RSCs were ready for discharge sooner than the patients who had EA. RSCs may have a place as a PMPOA in Gynae-Oncology patients requiring full-length midline incisions. Furthermore, if RSCs are implemented as a standard practice for PMPOA it may have a health-economic benefit.

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