engleski

Quality of analgesia with multi-versus two few-hole catheters in patients after colorectal surgery

Background and Purpose: Continuous wound infusionwith local anaesthetics is an effective method in multimodal postoperative pain therapy after colorectal surgery. The choice of optimal type of wound catheter, fewor multi-hole is still controversial. The aim is to evaluate the analgesic potential of these two catheter types. Materials and Methods: Forty patients undergoing colorectal surgery were randomized to intraoperative placement of two epidural catheters (Group EC) or multi-hole catheter (Group WC) in the wound above the fascia. Patients received 0.25% levobupivacaine (Group WC) with 10 mL bolus through the wound catheter followed by an infusion of 6 mL/h during 48 h, or the same protocol with equally divided levobupivacaine doses through two epidural catheters (Group EC). Simultaneously, patient-controlled analgesia provided intravenous morphine. Pain was evaluated postoperatively with 4-point verbal scale (VRS) for the first 2 h, with Visual Analogue Scale at rest (VAS r), and during coughing (VAS c) every 6 h for the first 48 h. Results and Conclusions: No significant difference in morphine consumption was observed between groups. There were no significant differences in VRS scores between the groups (p=0, 756). VAS scores were significantly lower in Group WC in rest (rWC, p=0, 007) and coughing (cWC, p=0, 018) for the 6 h, 12 h, and 24 h postoperatively. In the period 30–48 h there was no difference between groups. We conclude that levobupivacaine infusion through multi-hole catheter provides better quality of postoperative analgesia compared with two epidural catheters for the first 24 h.

Regional anesthesia; Infiltration anesthesia; Pain; Colorectal surgery

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