Surgically performed rectus sheath block – Effect of morphine added to bupivacaine versus bupivacaine only: A prospective randomized controlled double blinded trial

BackgroundExtended abdominal midline incision in laparotomies is associated with severe postoperative pain that is impacted badly on all body systems; proper management of this pain is essential for patient comfort and to minimize these bad impacts. Bilateral rectus sheath block (BRSB) is an option to achieve this.Methods50 Adult patients classified ASA1 and ASA2 submitted to extended abdominal midline incision were included. Bilateral rectus sheath catheters (BRSCs) were placed surgically during abdominal closure for BRSB. Patients were randomly assigned into 2 groups: in group 1(morphine group); a mixture of bupivacaine and morphine was used for BRSB, while in group 2 (bupivacaine group), only bupivacaine was used for BRSB.ResultsThere was a significant reduction in visual analogue scale (VAS) at rest and mobilization in the morphine group compared to bupivacaine group during 6th, 12th and 18th postoperative hours with P values: 0.001, 0.007, 0.04 and 0.003, 0.006, 0.036 during the same periods, respectively.ConclusionAddition of morphine to local bupivacaine for BRSB was effective and safe technique to achieve good quality of postoperative analgesia in patients submitted to extended midline abdominal incision.