Background and Aims: The primary objectives of the study were to compare the efficacy of analgesia, in terms of Numerical Rating Scale scores, achieved by continuous pre-peritoneal infiltration and continuous epidural infusion, and to assess the total amount of opioid consumption in the immediate postoperative period at 0, 6, 12, 24, 48 and 72 h. The secondary objectives of the study were to compare haemodynamic stability, in terms of heart rate, and blood pressure variations, particularly the frequency and severity of hypotension and total amount of fluid administered in the first 72 h of the postoperative period. Methods: This time-bound, prospective comparative observational study included a total of 80 patients. Eligible participants were allocated into two groups of 40 each based on a pre-defined protocol. Group E received a continuous epidural infusion of 0.2% ropivacaine, while Group P received a continuous pre-peritoneal infusion of 0.2% ropivacaine via catheter. Both the groups also received patient-controlled analgesia with opioids as part of a standardised post-operative pain regimen. Results: In our study, the proportion of patients with successful control of postoperative pain was 80% in the pre-peritoneal infusion group compared to 70% in the epidural group ( P < 0.05). We observed that both modalities provided adequate analgesia over 72 h with a similar requirement of supplemental narcotics ( P = 0.272). However, patients receiving pre-peritoneal infusion showed better haemodynamic stability after 72 h of surgery than those receiving epidural analgesia ( P = 0.211). Conclusions: While both continuous epidural and pre-peritoneal infusions of ropivacaine provided effective analgesia and reduced opioid consumption in the postoperative period, our findings highlighted a clinically significant advantage in greater haemodynamic stability with the pre-peritoneal approach.
Sengupta et al. (Thu,) studied this question.