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Rectus sheath catheter

Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Principles of enhanced recovery after surgery (ERAS(®)) protocols are well established, with the primary goal of optimizing perioperative care and recovery. The use of multimodal analgesia is a key component of these protocols, including regional analgesia techniques such as thoracic epidural analgesia (TEA), transversus abdominis plane (TAP), rectus sheath blocks or continuous wound infiltration (CWI)/catheters, and spinal anesthesia. We compare and contrast regional anesthesia approaches in different institutional colorectal surgery ERAS protocols...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
P J Cowlishaw, P J Kotze, L Gleeson, N Chetty, L E Stanbury, P J Harms
Effective analgesia after midline laparotomy surgery is essential for enhanced recovery programs. We compared three types of continuous abdominal wall block for analgesia after midline laparotomy for gynaecological oncology surgery. We conducted a single-centre, double-blind randomised controlled trial. Ninety-four patients were randomised into three groups to receive two days of programmed intermittent boluses of ropivacaine (18 ml 0.5% ropivacaine every four hours) via either a transversus abdominis plane (TAP) catheter, posterior rectus sheath (PRS) catheter, or a subcutaneous (SC) catheter...
July 2017: Anaesthesia and Intensive Care
Kristen A Lee, Andrew Cha, Mark H Kumar, Combiz Rezayat, Clifford M Sales
OBJECTIVE: We sought to assess the early success and safety of catheter-directed, ultrasound-assisted (CDUA) thrombolysis for acute pulmonary embolism (PE) in patients deemed to be "high risk" for thrombolytic therapy. METHODS: A retrospective evaluation of patients who underwent CDUA pulmonary thrombolysis in our practice during 39 months is reported. There were 91 patients considered, all of whom presented with acute PE as diagnosed by computed tomography angiography...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Sumitra G Bakshi, Amol Mapari, T S Shylasree
BACKGROUND: Opioid-sparing pain management is important for Enhanced Recovery After Surgery. Rectus sheath (RS) blocks are emerging as a promising modality for pain relief following midline laparotomy; however, there are limited prospective clinical trials testing their efficacy. The purpose of this randomized-controlled trial is to assess the morphine-sparing effect of local anesthetic (LA) boluses through RS catheters following elective gynecological oncology surgery. METHOD: After patients' informed consent, bilateral RS catheters were placed intraoperatively in 74 females (American Society of Anesthesiologists physical status I-II) undergoing elective midline laparotomy under general anesthesia...
December 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesth├ęsie
Monika A Krezalek, Nicolas Bonamici, Brittany Lapin, JoAnn Carbray, Jose Velasco, Woody Denham, John Linn, Michael Ujiki, Stephen P Haggerty
BACKGROUND: Success of peritoneal dialysis depends on the durability of the peritoneal dialysis catheter, which in turn depends on insertion technique. Catheter-related complications are among the main reasons for peritoneal dialysis failure. Techniques showing evidence of improved catheter function include rectus sheath tunnel, selective omentopexy, and adhesiolysis. METHODS: Single-institution retrospective review of consecutive peritoneal dialysis catheter insertions was performed between 2004 and 2014...
October 2016: Surgery
Abdelazeem Ali Eldawlatly, Abdullah Aldohayan
No abstract text is available yet for this article.
July 2016: Saudi Journal of Anaesthesia
Amir Keshvari, Mohammad Reza Keramati, Mohammad Reza Nassajian, Mehrzad Mohsenipour, Mohammad Kazem Nouritaromlou
BACKGROUND: Using a proper laparoscopic trocar for making a downward rectus sheet tunneling (RSHT) during the implementation of peritoneal dialysis (PD) catheters leads to a longer survival of catheter and less catheter dysfunction. As no specific laparoscopic trocar has been invented for insertion of PD catheters, we designed a new trocar. In this article, we describe specifications of our new invented trocar for the first time. We will describe our experience with it in our patients as well...
December 2016: Surgical Endoscopy
Mihaela Visoiu
PURPOSE OF REVIEW: Effective analgesia is necessary for optimal recovery after surgery, but children often do not attain adequate postoperative pain control. This review examines the current trends in paediatric regional anaesthesia. RECENT FINDINGS: Better pain assessment and therapeutic regimens are needed for our patients. Trunk blocks such as paravertebral, transversus abdominis plane, rectus sheath and ilioinguinal/iliohypogastric are becoming a popular means of providing analgesia for thoracic and abdominal procedures...
October 2015: Current Opinion in Anaesthesiology
Sumitra Bakshi, Amol Mapari, Rohit Paliwal
Epidural analgesia, though the gold standard of post-operative pain management for laparotomies, is associated with limitations and is contraindicated in many patients. Opioid-based pain management, which is an alternative to epidural, has been implicated in post-operative nausea, vomiting, and ileus. We report successful management of post operative pain with ultrasound guided rectus sheath (RS) catheters. RS block is a promising alternative in scenarios were epidural is contraindicated, has failed or in case of unexpected change in the surgical plan...
February 2015: Indian Journal of Anaesthesia
Kate M Wilkinson, Anton Krige, Sarah G Brearley, Steven Lane, Michael Scott, Anthony C Gordon, Gordon L Carlson
BACKGROUND: Thoracic epidural analgesia (TEA) is recommended for post-operative pain relief in patients undergoing major abdominal surgery via a midline incision. However, the effectiveness of TEA is variable with high failure rates reported post-operatively. Common side effects such as low blood pressure and motor block can reduce mobility and hinder recovery, and a number of rare but serious complications can also occur following their use.Rectus sheath catheters (RSC) may provide a novel alternative approach to somatic analgesia without the associated adverse effects of TEA...
October 21, 2014: Trials
Bikash Bhattarai, Meenakshi Ghosh, Abhisekh Sinha Ray, Saurav Pokharel, Rakesh Vadde, Vikram Oke, Marie Frances Schmidt, Danilo Enriquez, Joseph Quist, Anita Pandey, Saveena Manhas
Miscellaneous Case Report Posters IIISESSION TYPE: Affiliate Case Report PosterPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Rectus Sheath Hematoma (RSH) is a rare but important clinical entity that can mimic acute intra abdominal pathology and therefore should be in the differentials of acute abdomen. Although it mainly occurs in patients receiving anticoagulation therapy intractable coughing can also cause RSH. Here, we report a case of RSH that occurs secondary to intractable coughing in an asthmatic...
October 1, 2014: Chest
Robert Wu, Allan Okrainec, Todd Penner
BACKGROUND: Laparoscopic peritoneal dialysis catheter (LPDC) implantation using nitrous oxide (N2O) pneumoperitoneum under procedural sedation is a technique that has many advantages over conventional insertion methods. The purpose of this study was to review the LPDC insertion results at our center. METHODS: Data from 87 consecutive patients who underwent LPDC insertion was retrospectively reviewed. All procedures were attempted under procedural sedation. After patients received intravenous and local anesthesia, a N2O pneumoperitoneum was established...
January 2015: World Journal of Surgery
J E Kohler, J S Friedstat, M A Jacobs, B B Voelzke, H M Foy, R W Grady, J S Gruss, H L Evans
PURPOSE: A 40-year-old man with congenital midline defect and wide pubic symphysis diastasis secondary to bladder exstrophy presented with a massive incisional hernia resulting from complications of multiple prior abdominal repairs. Using a multi-disciplinary team of general, plastic, and urologic surgeons, we performed a complex hernia repair including creation of a pubic symphysis with rib graft for inferior fixation of mesh. METHODS: The skin graft overlying the peritoneum was excised, and the posterior rectus sheath mobilized, then re-approximated...
August 2015: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Nikhil G Thaker, Antonios Mammis, Daniel S Yanni, Rahul Singh, Peter W Carmel
Distal ventriculo-peritoneal shunt migration and extra-peritoneal CSF pseudocyst formation are unusual complications of shunt placement. We present a 65-year-old-female who received a subgaleal-peritoneal shunt to decompress a post-surgical subgaleal fluid collection. Eight weeks later, shunt series showed tight coiling of the distal catheter, and operative exploration found the distal shunt tip to have migrated superficial to the rectus sheath, where it had become encapsulated in a pre-peritoneal CSF pseudocyst...
2010: Journal of Surgical Case Reports
Mandy Layzell
Managing pain following major abdominal surgery remains a challenge. Traditionally, patient-controlled analgesia (PCA) or epidural analgesia have been used, which have improved post-operative pain and the patient experience, but have presented some problems in recovery. PCA can cause adverse effects, including sedation, nausea, vomiting, and prolonged gastric ileus. While epidurals do have some advantages over PCA, there are risks involved related to catheter insertion and adverse effects, such as hypotension and motor blocks which limit mobility...
June 24, 2014: Nursing Standard
Arisa Hotta, Yuuki Yagi, Saaya Hakata, Yae Tsumura, Motoko Shimizu, Ayako Kukida, Ai Nakamoto, Noriko Yoshikawa, Naoko Oohira, Shigeki Tatekawa
Ultrasound-guided peripheral nerve blocks in the abdominal wall, such as transversus abdominis plane block (TAP block) and rectus sheath block, are now widely used. We report a case of Leriche's syndrome treated with safe and effective analgesia after laparotomy by abdominal wall block and continuous infusion. A 61-year-old man diagnosed with Leriche's syndrome underwent Y-graft replacement for an abdominal aortic aneurysm. Preoperative enhanced and 3-dimensional CTs showed many collateral arterial systems, especially in the right abdominal wall...
December 2013: Masui. the Japanese Journal of Anesthesiology
A R Godden, M J Marshall, A S Grice, I R Daniels
INTRODUCTION: Epidural anaesthesia (EA) has been the accepted standard for postoperative analgesia in open abdominal surgery. However, it is not without significant risk. This study aimed to audit the effect of EA and ultrasonography placed rectus sheath catheters (RSCs) on analgesia as well as the incidence of postoperative complications following open colorectal cancer surgery. METHODS: A three-year retrospective case note review was undertaken of all patients undergoing open colorectal cancer surgery at the Royal Devon and Exeter Hospital NHS Foundation Trust who received either EA or RSC for postoperative analgesia under the care of the senior authors...
November 2013: Annals of the Royal College of Surgeons of England
J Bagenal, J Horsnell, J Loader, D West
No abstract text is available yet for this article.
September 2013: Annals of the Royal College of Surgeons of England
Thomas J Dutton, John S McGrath, Mark O Daugherty
OBJECTIVE: To report on the safety and efficacy of rectus sheath blocks, 'topped-up' using bilateral rectus sheath catheters (RSCs), in patients undergoing major open urological surgery. METHODS: The RSCs were inserted under ultrasound guidance into 200 patients between April 2008 and August 2011, of whom 106 patients underwent radical retropubic prostatectomy (RRP) and 94 underwent open radical cystectomy (ORC). A retrospective case-note review was undertaken. Outcomes included technical success and complication rates of the insertion and use of RSC, visual analogue pain scores, additional analgesia requirements and length of hospital stay (LOS)...
February 2014: BJU International
L Finch, A Phillips, N Acheson, P Dix, C Berry
Epidurals are frequently used as part of multi-modal perioperative analgesia. They are widely accepted as providing excellent pain relief but are associated with side-effects, have a significant failure rate and can limit a patient's mobility. We report on our use of rectus sheath catheters (RSCs), in conjunction with intravenous opiate via patient controlled analgesia (PCA), as a means of providing analgesia post-laparotomy for gynaecological oncological patients. Our experience is that this offers an alternative method of providing equivalent analgesia, avoiding the risks associated with epidural use and possibly has a role in reducing length of patient stay, although this requires further investigation...
July 2013: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
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