Burnell Phillippa, Coates Rachael, Dixon Steven, Grant Lucy, Gray Matthew, Griffiths Ben, Jones Mike, Madhavan Anantha, McCallum Iain, McClean Ross, Naru Karen, Newton Lydia, O'Loughlin Paul, Shaban Fadlo, Sukha Anisha, Somnath Sameer, Shumon Syed, Harji Deena
Department of Academic Surgery, University of Newcastle, Newcastle upon Tyne, UK.
BMJ Open. 2016 Sep 6;6(9):e008810. doi: 10.1136/bmjopen-2015-008810.
Laparoscopic surgery combined with enhanced recovery programmes has become the gold standard in the elective management of colorectal disease. However, there is no consensus with regard to the optimal perioperative analgesic regime in this cohort of patients, with a number of options available, including thoracic epidural spinal analgesia, patient-controlled analgesia, subcutaneous and/or intraperitoneal local anaesthetics, local anaesthetic wound infiltration catheters and transversus abdominis plane blocks. This study aims to explore any differences in analgesic strategies employed across the North East of England and to assess whether any variation in practice has an impact on clinical outcomes.
All North East Colorectal units will be recruited for participation by the Northern Surgical Trainees Research Association (NoSTRA). Data will be collected over a consecutive 2-month period. Outcome measures will include postoperative pain score, postoperative opioid analgesic use and side effects, length of stay, 30-day complication rates, 30-day reoperative rates and 30-day readmission rates.
Ethical approval for this study has been granted by the National Research Ethics Service. The protocol will be disseminated through NoSTRA. Individual unit data will be presented at local meetings. Overall collective data will be published in peer-reviewed journals and presented at relevant surgical meetings.
腹腔镜手术联合加速康复方案已成为结直肠疾病择期治疗的金标准。然而,对于这类患者的最佳围手术期镇痛方案尚无共识,有多种选择,包括胸段硬膜外脊髓镇痛、患者自控镇痛、皮下和/或腹腔内局部麻醉、局部麻醉伤口浸润导管和腹横肌平面阻滞。本研究旨在探讨英格兰东北部采用的镇痛策略的差异,并评估实践中的任何差异是否会对临床结果产生影响。
所有英格兰东北部的结直肠科室将由北方外科实习医生研究协会(NoSTRA)招募参与研究。数据将在连续2个月的时间内收集。结果指标将包括术后疼痛评分、术后阿片类镇痛药的使用及副作用、住院时间、30天并发症发生率、30天再次手术率和30天再入院率。
本研究已获得国家研究伦理服务机构的伦理批准。该方案将通过NoSTRA进行传播。各科室的个体数据将在当地会议上展示。总体汇总数据将发表在同行评议期刊上,并在相关外科会议上展示。