Pain Relief After Colorectal Surgery: Single-shot Spinal Combined With Painbuster® vs Painbuster® Alone. A Pilot Randomised Controlled Trial
Description:
This is a pilot randomised controlled trial
Hypotheses –
Following colorectal surgery, spinal anaesthesia combined with a continuous infusion of local
anaesthetic into the surgical wound provides
1. better pain relief
2. a reduced stress response
when compared to the use of continuous infusion of local anaesthetic into the surgical wound
alone.
Patients undergoing surgical resection for colorectal cancer will be randomised to receive
either
1. A single shot of spinal anaesthesia plus a continuous infusion of local anaesthetic into
the surgical wound or
2. Continuous infusion of local anaesthetic into the surgical wound
Spinal Anaesthesia
The spinal anaesthetic (SA) with be placed after commencement of general anaesthesia this
will ensure the patients remain blinded to the intervention. SA will be performed in the
lateral position using a midline approach. L3/4 interspace will be identified using Tuffier’s
as the anatomical landmark. After confirmation of correct placement using a 25G Whitacre
needle, 12.5 mg of hyperbaric Bupivacaine in a mixture with 500mcg Diamorphine will be
injected intrathecally.
Infusion of local anaesthetic
The catheter through which the infusion of local anaesthetic will be given, will be placed by
the surgeon at the end of the procedure in a location determined by the surgical approach. A
bolus dose of 20ml 0.25% L-Bupivacaine will be injected down the catheters prior to the
connection of the elastomeric pump which will also contain 270ml 0.25% L-Bupivacaine
General anaesthesia will be managed in the same way for both groups
Condition:
Colorectal Cancer
Treatment:
Spinal and infusion of local anaesthetic
Start Date:
September 2013
Sponsor:
York Teaching Hospitals NHS Foundation Trust
For More Information:
https://clinicaltrials.gov/show/NCT02210260