CAMELOT is a multi-centre, randomised sham-controlled trial of rectus sheath catheter-delivered local anaesthetic infusion compared with usual care in patients undergoing
emergency bowel surgery.
Background
In the UK, around 30,000 patients each year undergo a major surgical operation called an
emergency laparotomy to treat an acute life-threatening problem within the abdomen. During
the procedure, a large, vertical midline incision is made into the abdomen to allow the
surgeon to diagnose and treat serious conditions including internal bleeding, sepsis or a
blockage to the bowel. Whilst the midline incision provides quick and easy access to the
abdominal cavity, it cuts the nerves crossing the abdominal wall, causing severe
postoperative pain, hindering early recovery and discharge.
Rectus sheath blockade is a promising modality for opioid-sparing pain relief following
midline incision laparotomy. However, there is limited randomised controlled trial (RCT) data
and none in the emergency setting.
Aims
The primary objective is to assess whether the use of rectus sheath catheter (RSC)-delivered local anaesthetic infusion in addition to standard analgesia, is superior to standard analgesia without RSC for postoperative pain control in adult patients undergoing emergency laparotomy surgery. This will be defined by defined by recording an Overall Benefit of
Analgesia Score (OBAS) from the participant over the first 5 postoperative days.
Funding
This study is funded by the National Institute for Health Research (NIHR) Health Technology Assessment Programme. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR HTA or the Department of Health. The study protocol is published on the NIHR website.
Study Registration
This study is registered on the NHS Portfolio and ISRCTN.
Ethics Committee Approval
This study was approved by the Bromley Research Ethics Committee.