A comparison between thoracic epidural analgesia and rectus sheath catheter analgesia after open midline major abdominal surgery: randomized clinical trial.

BJS Open 2022; 6: zrac055.

Pain scores were improved after epidural analgesia for the first 24h (pain score 33 versus 50.5; P=0.018) in this study that included 131 procedures. After 72h, pain control was better with a rectus sheath catheter (4.5 versus 12.5; P=0.019), which was also more cost effective.

Comment: Perhaps the compromise is opiate analgesia to supplement the rectus sheath catheter.