Surgically performed rectus sheath block – Effect of morphine added to bupivacaine versus bupivacaine only: A prospective randomized controlled double blinded trial

Shabana, Amir M.; Dar, Manzoor Ahmad; Ghanem, Mohamed

doi:10.1016/j.egja.2013.07.002

Cited by 7 publications

(4 citation statements)

References 11 publications

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“…A key difference in methodology was the use of a fentanyl/levobupivacaine mixture in the Turky et al study and plain ropivacaine in the present study for the RSC boluses, and this addition of opiate to the infusion may account for the difference in findings. Indeed the 2013 study by Shabana et al showed superior analgesia when the local anaesthetic was combined with morphine for RSCA 35 . In addition Turky et al employed a more aggressive opiate rescue analgesia strategy, which may also explain the lower pain scores than in the present study 20 .…”

Section: Discussionmentioning

confidence: 99%

A comparison between thoracic epidural analgesia and rectus sheath catheter analgesia after open midline major abdominal surgery: randomized clinical trial

et al. 2022

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Background Rectus sheath catheter analgesia (RSCA) and thoracic epidural analgesia (TEA) are both used for analgesia following laparotomy. The aim was to compare the analgesic effectiveness of RSCA with TEA after laparotomy for elective colorectal and urological surgery. Methods Patients undergoing elective midline laparotomy were randomized in a non-blinded fashion to receive RSCA or TEA for postoperative analgesia at a single UK teaching hospital. The primary quantitative outcome measure was dynamic pain score at 24 h after surgery. A nested qualitative study (reported elsewhere) explored the dual primary outcome of patient experience and acceptability. Secondary outcome measures included rest and movement pain scores over 72 h, functional analgesia, analgesia satisfaction, opiate consumption, functional recovery, morbidity, safety, and cost-effectiveness. Results A total of 131 patients were randomized: 66 in the RSCA group and 65 in the TEA group. The median (interquartile range; i.q.r.) dynamic pain score at 24 h was significantly lower after TEA than RSCA (33 (11–60) versus 50.5 (24.50–77.25); P = 0.018). Resting pain score at 72 h was significantly lower after RSCA (4.5 (0.25–13.75) versus 12.5 (2–13); P = 0.019). Opiate consumption on postoperative day 3 (median (i.q.r.) morphine equivalent 17 (10–30) mg versus 40 (13.25–88.50) mg; P = 0.038), hypotension, or vasopressor dependency (29.7 versus 49.2 per cent; P = 0.023) and weight gain to day 3 (median (i.q.r.) 0 (−1–2) kg versus 1 (0–3) kg; P = 0.046) were all significantly greater after TEA, compared with RSCA. There were no significant differences between groups in other secondary outcomes, although more participants experienced serious adverse events after TEA compared with RSCA, which was also the more cost-effective. Conclusions TEA provided superior initial postoperative analgesia but only for the first 24 h. By 72 hours RSCA provides superior analgesia, is associated with a lower incidence of unwanted effects, and may be more cost-effective.

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Section: Discussionmentioning

confidence: 99%

A comparison between thoracic epidural analgesia and rectus sheath catheter analgesia after open midline major abdominal surgery: randomized clinical trial

et al. 2022

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“…assessed RSB-induced analgesia after abdominal surgeries. [ 37 ] Before closure of midline incisions of 25 patients, RSB was applied via a catheter, inserted under direct vision, with 20 mL of 0.25% isobaric bupivacaine on each side. At 6 hours postoperatively, the mean VAS value at rest and on movement is almost comparable with VAS values in this study.…”

Section: Discussionmentioning

confidence: 99%

Surgically-assisted abdominal wall blocks for analgesia after abdominoplasty: A prospective randomized trial

2018

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“…Laparotomies that necessitate midline incisions were commonly accompanied by postoperative pain, typically associated with neuroendocrine stress response [1,2].…”

Section: Introductionmentioning

confidence: 99%

Rectus Sheath Block Efficacy for Patients Who Underwent Emergency Midline Laparotomy at a Resource Limited Setting in Northcentral Ethiopia, 2019.

Teshome

Fenta

Hunie

et al. 2020

Preprint

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Background Midline laparotomy is associated with severe postoperative pain. Literature showed controversial results regarding the efficacy of the rectus sheath block. Objective To assess the effectiveness of rectus sheath block efficacy for patients who underwent emergency midline laparotomy at a resource limited setting in Northcentral Ethiopia, from February 01 to March 30, 2019. Methods This is a prospective cohort study that recruits 60 patients who underwent emergency midline laparotomy. Independent t-test and Manny Whitney tests were used for numeric data while Chi-Square or Fisher exact test was used for categorical variables. P-values < 0.05 were considered as statistically significant. Results The median (interquartile range) of the numeric rating scale score at the recovery was 3(3-4) for an exposed group and 4.5(3-4.5) for an unexposed group with a p-value of 0.039. Postoperative numeric rating scale scores at 3 rd , 6 th , 12 th , and 24 th hours were statistically significantly lower in the exposed group. Postoperative tramadol consumption in 24 hours was significantly lower with a p-value of 0.0001 for the rectus sheath group. Conclusions For surgeries done through midline laparotomy, adding bilateral rectus sheath block (BRSB) at the end of the operation might be an effective postoperative analgesia option.

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Surgically performed rectus sheath block – Effect of morphine added to bupivacaine versus bupivacaine only: A prospective randomized controlled double blinded trial

Cited by 7 publications

References 11 publications

A comparison between thoracic epidural analgesia and rectus sheath catheter analgesia after open midline major abdominal surgery: randomized clinical trial

A comparison between thoracic epidural analgesia and rectus sheath catheter analgesia after open midline major abdominal surgery: randomized clinical trial

Surgically-assisted abdominal wall blocks for analgesia after abdominoplasty: A prospective randomized trial

Rectus Sheath Block Efficacy for Patients Who Underwent Emergency Midline Laparotomy at a Resource Limited Setting in Northcentral Ethiopia, 2019.

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