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PWE-299 Evaluation of wound infusion catheters as analgesia in elective and emergency colorectal surgery
  1. C Mann1,
  2. D Couch1,
  3. A Roberts2,
  4. A Packham3,
  5. J Tring3,
  6. A Miller1
  1. 1Department of Colorectal Surgery
  2. 2University Hospitals of Leicester, Leicester, UK
  3. 3Department of Anaesthesia, University Hospitals of Leicester, Leicester, UK

Abstract

Introduction Wound infusion catheters are becoming increasingly popular to control post-operative pain as an alternative to thoracic epidurals, which have a significant failure rate and complication profile. The aim of this was to review our experience with the OnQ® (Bbraun) wound infusion catheter in patients undergoing elective and emergency colorectal laparotomy in terms of usage, safety and efficacy.

Method Retrospective analysis of a prospectively maintained database of all patients undergoing elective and emergency colorectal laparotomy at Leicester Royal Infirmary October 2013–2014. Emergency patients ventilated post-operatively were excluded. OnQ® wound catheters were inserted in the preperitoneal plane in combination with morphine PCA, and delivered levobupivicaine 0.25% 5 ml/hr for 56 h.

Results Since 2008, 727 patients have received wound catheters as analgesia following colorectal laparotomy. Complication rate was low (1.5%), mainly related to catheter displacement (n = 11). During the 12 month study period 179 patients underwent elective colorectal laparotomy. 120 of these had an OnQ® inserted (67%), with a significantly lower total morphine consumption compared to PCA alone (109 vs 193 mg p < 0.05 Mann-Whitney). 239 patients underwent emergency laparotomy during this period. Of these, only 28 had an OnQ® inserted (11%), again with a significantly lower total morphine consumption compared to PCA alone (92 vs. 154 mg p < 0.05 Mann-Whitney). The only complications directly related to the OnQ® during this period were due to catheter displacement (n = 2).

Conclusion Wound infusion catheters are safe, effective and simple to use. They are a good addition to multimodal analgesia in patients undergoing elective colorectal laparotomy. They are equally effective in patients undergoing emergency laparotomy, however are considerably under-used - an area which will be addressed.

Disclosure of interest None Declared.

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