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Background and Aims Inadequate analgesia after major abdominal surgery is associated with adverse patient outcomes. We aimed to compare the analgesic effect of intrathecal morphine to epidural analgesia in patients undergoing laparoscopic colorectal resection for cancer.

Methods Patients with colorectal cancer undergoing laparoscopic colorectal resection at the University Hospital of Split were divided into the Epidural group or Spinal group. The primary outcome was pain intensity at rest measured with the Numeric Rating Scale (0 = no pain and 10 = worst pain) 24 hours after surgery. Secondary outcome measures were analgesic consumption, time to rescue analgesia, patient satisfaction, quality of sleep, length of hospital stay, time to return of bowel function, and adverse events (such as respiratory depression, nausea or vomiting, hypotension and bradycardia).

Results Twenty-two patients were eligible, but 5 were excluded due to technical difficulties or conversion to open surgery. Seventeen patients with a median age of 64 years were included (9 epidural, 8 Spinal group). Based on preliminary results, the median pain at rest at 24 hours was 2 (IQR 0-5) in the Epidural and 0.5 (IQR 0-2.75) in the Spinal group. The time to first rescue analgesia was 60 min in the Epidural (IQR 260min) and 45 min in the Spinal group (IQR 63). There was no respiratory depression, postoperative nausea, hypotension, bradycardia, or shivering reported.

Conclusions Based on preliminary results, patients in both spinal and epidural analgesia groups experienced mild pain (NRS<3) at rest at 24 hours after laparoscopic colorectal cancer surgery. No serious adverse events were currently observed.