Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission

Background and Aims The purpose of this study was to compare the postoperative analgesic requirement of opioid as rescue analgesia, postoperative pain scores, time to ambulation, perioperative blood pressures, length of hospital stay (LOS), and adverse event rates.

Methods This was a retrospective cross sectional observational study of adult orthopaedic patients (ages 18 - 65 years) undergoing unilateral lower limb surgery (25 - CEA and 25 - CPNB), conducted in Evercare Hospital Dhaka, Bangladesh. Approval for the study was obtained from the hospital ethical clearance committee and the duration of the study was 6 months from January 2023 to December 2023.

Results The CEA group had a longer time to ambulation (62.7 ± 4.93 hours versus 32.5 ± 4.69 hours, p > 0.05). The CEA group demonstrated more postoperative hypotension (MAP: 64.7 ± 3.6 mmHg) than CPNB group (MAP: 76.8 ± 8.3 mmHg) with p > 0.05. There was a significant difference in the length of stay between the CEA and CPNB groups (4.98 versus 2.93, p > 0.05). There was no statistically significant difference between the rates of pruritus, lightheadedness, and altered mental status. The CEA group demonstrated higher rates of constipation (67.9% versus 5.3%, p > 0.05), and urinary retention (45.8% versus 0%, p > 0.05).

Conclusions CPNB and CEA demonstrated equivalent postoperative opioid use after unilateral lower extremity surgery. A lower complication rate and a decreased time to ambulation were seen in the CPNB group. A prospective multicentre study could further facilitate the incorporation of CPNB in postoperative pain management protocol in Bangladesh.