Background and Aims Local anaesthetic catheters for fascial planes have become a crucial part of modern acute pain management strategies for trauma and post-operative patients. Whilst there is agreement that chest wall, abdominal and pelvic catheters are highly effective analgesia options it remains unclear which local anaesthetic is best and what the best mode of delivery is most efficacious and safe for patients. A Survey was conducted to look at current practice across United kingdom hospitals and assess variation.
Methods Survey via email of United Kingdom anaesthetic department regimes for fascial plane catheters including details on drug type, concentration and details of regime were requested. Fascial Plane catheters including Serratus Anterior, Erector Spinae, Rectus Sheath and Fascia Iliacus were all included.
Results 12 of 24 hospitals responded. 1 hospital used Ropivacaine (0.2%) and remaining 11 used Levobupivacaine with a range of strengths from 0.1% to 0.25% concentrations. 9 of 12 used continuous infusion regimes and 3 used bolus regimes ( 2 automated via pumps and 1 manual via clinician). None of the hospitals had the same infusion regimes. Rates varied from fixed 5 mls/hr to ranges from 1–14 mls/hr of 0.125% Levobupivaine.
Conclusions Continuous regimes are still popular despite common belief that boluses should theoretically be more beneficial in opening up the fascial plane spaces. There should be more research into the best method to achieve efficacious and safe infusions for patients and perhaps a working group of experts should suggest best practice until appropriate research has been conducted.
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