The rectus sheath block for post-operative pain: a medical intra-operative approach - abstract

ABSTRACT

This study was designed to test the hypothesis that if early post-operative pain is adequately controlled then subsequent analgesia would be more effectively maintained. An intraoperative rectus sheath block was designed in which about 20 cc of 0.5 per cent bupivacaine were infiltrated into the plane containing the segmental spinal nerves within the rectal sheath just prior to wound closure. Twenty-six adult patients undergoing abdominal surgery via a mid-line incision were randomly allocated to 2 groups which were matched for age, sex, type of procedure and size of patient. The control group of 10 patients received pethidine 100 mg/i.m. every 4 hours for the first 24 post-operative hours. The rectus sheath group of 16 patients, in addition to the rectus sheath block, also received pethidine 100 mg/i.m. every 4 hours for 24 hours post-operatively. Pain scoring was done at six hours and twenty-four hours post-operatively, using a verbal rating scale. Statistical analysis, using The Mann-Whitney U test at the 5 per cent level, showed that post-operative analgesia, using the rectus sheath block and intra muscular pethidine, was superior to that obtained by pethidine alone at both 6 and 24 hours post-operatively (AU)