Abstract No.: ABS2571: Comparison of postoperative analgesia and opioid requirement with thoracic epidural vs. continuous rectus sheath infusion in midline incision laparotomies under general anaesthesia. A prospective randomised controlled study.

BACKGROUND & AIMS: To assess and compare the effect of bilateral continuous rectus sheath infusion (CRSB) for postoperative analgesia with continuous thoracic epidural infusion (TEA) in patients undergoing midline incision laparotomies METHODS: A prospective, randomised study involving 60 patients with American Society of Anesthesiologists physical status I to III, planned for elective laparotomy were enrolled for the study. Patients were randomly allocated into two groups: TEA group: an epidural was sited before induction of general anaesthesia (GA); CRSB group: bilateral ultrasound-guided RSB catheters were placed at the end of the surgical procedure, before extubation. Both groups received continuous 0.2% ropivacaine infusion. They were followed for two post-operative days (POD). Opioid requirement and post-operative pain at rest, coughing and moving were noted. Statistical analysis was done using SPSS 21.0 RESULTS: Opioid consumption in both groups was comparable, for the first two post-operative days with no statistically significant difference. Pain scores were comparable among the groups at all times except POD 0 (4 h and 12 h postop) and POD 1 (8 AM and 12PM), where lower pain scores were observed in CRSB Group. CONCLUSION: As a part of the multimodal analgesia technique, CRSB offers a reliable, safe, and effective alternative to TEA