218 Let’s talk about rectus sheath catheters. A retrospective audit of analgesic techniques used in emergency laparotomy

Abstract

Registry of India (CTRI/2019/06/019656) following approval from Max Healthcare Ethics Committee. 80 adult female patients (ASA grades I&II) undergoing modified radical mastectomy were randomly allocated into two groups to receive PECS block and ESP block with 30 ml of 0.375% Levobupivacaine, after induction of anaesthesia. Fentanyl was administered for postoperative pain relief via PCA pump. Outcomes such as Numerical Rating Scale (NRS) scores to assess pain, time to first rescue analgesia, intraoperative and postoperative fentanyl requirement, incidence of PONV, patient satisfaction etc. were statistically analysed. Results Patients given modified PECS block experienced significantly better quality of analgesia and perceived the block to be more satisfactory with respect to pain relief and ability to sleep (p < 0.001). With PECS block, patients showed significantly lower mean NRS scores at 24-hours postoperatively (1.18 ±1.13 vs 2.65 ±0.98)(p<0.001) and total fentanyl consumed was considerably lesser (61.25 ± 41.58 mcg vs 183.75 ± 51.13 mcg)(p<0.001). Conclusions We found that modified PECS block provided superior postoperative analgesia than ESP block in patients undergoing MRM without any adverse effects.