Rectus sheath catheters versus thoracic epidural analgesia for pain management after open surgery: systematic review and meta-analysis
Pooled result · Postoperative painResult — go to the resultSMD −0.35 95% CI −2.01 to 1.32Authors' conclusion
RSCs provide analgesia comparable to TEA with fewer complications, facilitating earlier recovery and potential cost savings.
Study context
- Population
- Adults undergoing open abdominal, pelvic, thoracic, or vascular surgery
- Participants
- 2,162 adults · 31 studies
- Comparison
- Rectus sheath catheters vs thoracic epidural analgesia
- Outcome
- Postoperative pain
Methodological detailsmeta-analysis of randomized trials, prospective and retrospective comparative studies included
- Meta-analysis of randomized trials
- Prospective and retrospective comparative studies included
Pooled result
As reported in the abstract
SMD
−0.35
95% CI −2.01 to 1.32
RSCs vs TEA
SMD −0.35 (95% CI −2.01 to 1.32)
Further pooled results
| Outcome | SMD (95% CI) | |
|---|---|---|
| Opioid consumption | −0.32 (−1.71 to 1.07) | |
| −2−1012Difference (linear scale) |
Bowel function recovery, urinary retention, time to mobilization, hospital LOS
- No differences observed
Costs
- Lower costs with rectus sheath catheters (RSCs); savings per case
- $500 to $6632
Urinary retention and mobilization (subgroups: non-visceral surgery, non-laparotomy incisions)
- Less urinary retention and earlier mobilization with RSCs suggested
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| HypotensionSignificantly reduced risk with RSCs | 0.40 (0.26–0.60) | |
| 0.20.5125Relative risk (log scale) |
Original publication
Rectus sheath catheters versus thoracic epidural analgesia for pain management after open surgery: systematic review and meta-analysis. Br J Surg. Published 13 May 2026. doi:10.
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