Patients having emergency bowel surgery at 15 UK hospitals will be offered a new pain relief technique in a trial to help ease recovery and improve outcomes.
Dr Mark Edwards, consultant anaesthetist and researcher at the NIHR Southampton Biomedical Research Centre, will jointly lead the trial with Dr Ronelle Mouton from the University of Bristol.
Around 30,000 people need emergency bowel surgery each year in the UK. The surgery is performed for many different reasons, including bowel cancer complications or infection.
These are major operations for patients who tend to be elderly and often have additional health problems. After surgery, patients are usually cared for within intensive care units, but around one in 10 do not survive the immediate effects of surgery.
The surgery typically requires a large cut to be made straight down their middle. This leaves patients in considerable pain in the days following surgery.
This pain can cause them to avoid deep breaths, sometimes resulting in lung infections. In rare cases, patients may also go on to develop long-term pain which is difficult to treat.
Improving pain relief
The trial will give patients a new pain relief method, known as rectus sheath catheters. The catheters are inserted just under the rectus abdominis muscles, which run vertically down the centre of the belly. These abdominal muscles are what give people a six-pack.
Local anaesthetic will be slowly pumped through two of these catheters for three days after surgery. They will be given in addition to pain relief currently available to these patients, such as painkillers like morphine.
A control group will also have the catheters, but they won’t be inserted and will instead rest on the top of the skin. Patients will not be told which group they are in during the trial.
The researchers hope the trial will show rectus sheath catheters, compared with standard care, are a cost-effective way to improve pain relief for these patients.
They plan to start the trial next summer, with 750 patients taking part across 15 UK hospitals where the treatment is not already routinely in use.