Rectus Sheath Catheters Following Midline Laparotomy

Rectus sheath catheters (RSC) are used for postoperative analgesia following midline laparotomies. Local anesthetics are applied to the posterior rectus sheath via the RSC. The target structures are the anterior cutaneous branches of the spinal nerves Th7-Th12. RSC can be used in particular if thoracic epidurals are contraindicated (compromised coagulation), technically unfeasible or refused by the patient. The study investigates placebo-controlled weather RSC have a significant additional analgesic effect in a multimodal analgesic concept. Primary outcome parameters are the maximum pain score, the Quality-of-Recovery-15-Score (QoR-15GE) and the opioid consumption (morphine equivalents) in the first 72h postoperatively.

Inclusion Criteria: * Median laparotomy * Age over 18 years * Informed consent has been obtained Exclusion Criteria: * Local signs of inflammation * known allergy to local anesthetics used * chronic pain syndrome * drug addiction * post-operative ventilation that cannot be completed on the day of surgery * lack of consent or cooperation * pregnancy * participation in another medical study * sepsis