Improving Pain Relief Following Laparoscopic Ventral Hernia Repair
Status:
Withdrawn
Trial end date:
2018-08-01
Target enrollment:
Participant gender:
Summary
Aim
The general aim of this study is to improve post-operative pain and reduce morphine
consumption following laparoscopic ventral hernia repair (LVHR). We specifically aim to
conduct a randomized, double blinded, controlled trial to investigate the effect of
intra-peritoneal local anaesthesia infusions on post-operative morphine consumption and.
Methods:
Patients will be randomised by computer generated random numbers (random permutation) and
opaque envelope methods. At closure, one small 2mm catheter belonging to the AutoFuser pain
pump system will be placed in the peritoneal cavity between the onlay mesh and parietal
peritoneum. In the treatment arm patients will receive 275mL of 0.2% ropivacaine at 4mL/h. In
the placebo arm, 275mL of 0.9% normal saline will be used in a similar fashion. The infusions
will run for 68 hours total. All members involved in patient care (with the exception of one
independant research fellow) will be blinded to the above. After 68 hours the pump will be
stopped and the catheter will be removed. Assessment of post-operative pain will be performed
by visual analogue scale, and total opiate consumption will be collected and converted into
morphine equivalents.
Health significance:
Local anaesthesia has become an important addition to multimodal regimens of analgesia
following surgery. Recent studies have shown that local anaesthetic (LA) wound infiltration
has improved post-operative pain when compared with standard opioid regimens for pain relief.
Only one previous study looked at bupivacaine infusions into the hernia sac for three days
following LVHR. This study found no improvement in post-operative pain or morphine
consumption. We aim to demonstrate improved pain and reduced morphine consumption using an
alternative catheter insertion technique and ropivacaine as the desired LA agent.