Trial results comparing continuous preperitoneal analgesia (CPA) to continuous epidural analgesia (CEA) for pain control after colon and rectal surgery were posted on ClinicalTrials.gov on 2025-09-15. The study enrolled 98 participants to evaluate the efficacy of these two methods in managing postoperative pain for conditions including Colorectal Cancer.
Background
Colorectal cancer surgery, including procedures for colon and rectal cancer, can lead to substantial postoperative pain. Effective pain management is a critical component of patient care, influencing recovery, mobility, and overall well-being. Continuous epidural analgesia (CEA) is a well-established method for managing such pain. This study aimed to assess whether continuous preperitoneal analgesia (CPA), delivered via ON-Q Silver Soaker™ catheters, could offer equivalent pain control, potentially providing an alternative or complementary approach to standard care.
Trial design
This completed study enrolled 98 patients to compare the efficacy of two standard methods of analgesia. The conditions included Colon Cancer, Rectal Cancer, and Colonic Diverticulosis. The trial's purpose was to compare continuous preperitoneal analgesia (CPA), delivered through preperitoneally placed ON-Q Silver Soaker™ catheters, to continuous epidural analgesia (CEA). These two methods were evaluated for pain control in patients undergoing elective colon and rectal surgery, with efficacy measured by the Numeric Pain Scale (NPS) and the need for supplemental narcotic analgesics.
Key results
The trial collected postoperative Numerical Pain Score (NPS) measurements across several time points:
- Postoperative Numerical Pain Score-Day 0:
- For Continuous Preperitoneal Analgesia (CPA), the mean score was 3.9 (Standard Deviation 2.0) units on a scale.
- For Continuous Epidural Analgesia (CEA), the mean score was 2.6 (Standard Deviation 1.7) units on a scale.
- Postoperative Numerical Pain Score-Day 1:
- For Continuous Preperitoneal Analgesia (CPA), the mean score was 3.2 (Standard Deviation 1.8) units on a scale.
- For Continuous Epidural Analgesia (CEA), the mean score was 2.6 (Standard Deviation 1.9) units on a scale.
- Postoperative Numerical Pain Score-Day 2:
- For Continuous Preperitoneal Analgesia (CPA), the mean score was 2.6 (Standard Deviation 1.7) units on a scale.
- For Continuous Epidural Analgesia (CEA), the mean score was 2.1 (Standard Deviation 1.7) units on a scale.
- Postoperative Numerical Pain Score-Day 3:
- For Continuous Preperitoneal Analgesia (CPA), the mean score was 2.9 (Standard Deviation 1.9) units on a scale.
- For Continuous Epidural Analgesia (CEA), the mean score was 2.7 (Standard Deviation 1.9) units on a scale.
- Postoperative Numerical Pain Score-Day 4:
- For Continuous Preperitoneal Analgesia (CPA), the mean score was 3.1 (Standard Deviation 2.1) units on a scale.
- For Continuous Epidural Analgesia (CEA), the mean score was 2.7 (Standard Deviation 1.8) units on a scale.
- Postoperative Numerical Pain Score (NPS)- Post-Anaesthesia Care Unit (PACU):
- For Continuous Preperitoneal Analgesia (CPA), the mean score was 3.5 (Standard Deviation 2.8) units on a scale.
- For Continuous Epidural Analgesia (CEA), the mean score was 2.3 (Standard Deviation 2.5) units on a scale.
What this means
The results indicate that continuous epidural analgesia (CEA) generally provided lower mean postoperative pain scores compared to continuous preperitoneal analgesia (CPA) across most measured time points. For instance, in the Post-Anaesthesia Care Unit (PACU), the mean NPS for CEA was 2.3 compared to 3.5 for CPA. Similarly, on Day 0, CEA had a mean NPS of 2.6 versus 3.9 for CPA. While both methods aim to control pain, these findings suggest that CEA may offer superior pain reduction in the immediate postoperative period and over the first few days following colon and rectal surgery. This information can help clinicians in selecting appropriate pain management strategies for patients undergoing these surgical procedures, potentially leading to improved patient comfort and recovery outcomes.
Source
The data for this trial was sourced from ClinicalTrials.gov, a public registry of clinical studies. The results for study NCT01552226, titled "Compare Preperitoneal Analgesia to Epidural Analgesia for Pain Control After Colon and Rectal Surgery," were posted on 2025-09-15 on clinicaltrials.gov.