Date of Award
2020
Document Type
Dissertation
Degree Name
Master of Medicine (MMed)
First Supervisor/Advisor
Dr. Stanley Mugambi
Second Supervisor/Advisor
Dr. Abdallah Abdulkarim
Third Supervisor/Advisor
Dr. David Odaba
Department
General Surgery (East Africa)
Abstract
Background: Post-operative pain control is an important pillar in enhanced recovery after surgery. There is a paucity of data that compares efficacy of pain control between continuous local anaesthetic wound infusion and thoracic epidural analgesia in elective laparotomy patients
Objective: To evaluate pain control between continuous local anaesthetic wound infusion and thoracic epidural analgesia in elective laparotomy patients.
Design: A randomised, single-blind, controlled clinical trial.
Setting: Aga Khan University Hospital, Nairobi, Kenya.
Population: Patients undergoing elective laparotomy.
Methods: Thirty eight patients scheduled for elective laparotomy were randomized into two equal groups to receive either continuous local anaesthetic wound infusion or thoracic epidural analgesia. Data of the baseline characteristics, total morphine consumption at 72 hours, visual analogue scores and rates of adverse effects were collected.
Results: Baseline characteristics of the participants were similar. Continuous local anaesthetic wound infusion was equivalent to thoracic epidural analgesia in terms of total morphine consumption at 72 hours. Duration of hospital stay was shorter in the intervention arm however visual pain scores were equal between the two groups. Comparatively we observed more surgical site infections in the intervention arm with more dislodged catheters in the thoracic epidural arm.
Conclusion: Continuous local anaesthetic wound infusion provides an alternative modality in management of post-operative pain in patients who have undergone elective laparotomy.
Recommended Citation
Mwangi, D. G. (2020). Local anaesthetic wound infusion versus thoracic epidural analgesia for post-operative pain control following elective laparotomy: a randomised controlled trial (Unpublished master's dissertation). Aga Khan University, East Africa.