Quality of Recovery (QoR-15) following Administration of Intravenous versus Epidural Opioids or Non-opioids in Oncological Abdominal Surgeries under General Anaesthesia: An Randomised Controlled Study

Background and Aim: Postoperative pain management plays a pivotal role in recovery following oncological abdominal surgeries. Despite numerous analgesic strategies, there remains limited evidence comparing recovery outcomes between intravenous (IV) and epidural analgesia for both opioid and non-opioid agents. This study compares the effect of four analgesic regimens on recovery quality, using the validated quality of recovery-15 (QoR-15) questionnaire. Methods: The present randomised study was conducted in 82 patients scheduled for oncological abdominal surgeries under general anaesthesia, who were randomised into four groups ( n = 20): Group A (IV fentanyl), Group B (IV paracetamol), Group C (epidural bupivacaine) and Group D (epidural bupivacaine with fentanyl). QoR-15 scores were assessed preoperatively and at 24-h intervals until discharge. Secondary outcomes included pain scores (numerical rating scale), postoperative recovery (Aldrete score), bowel function return, feeding initiation, ward transfer time, hospital stay and side effects. Data were analysed using IBM SPSS v22. Continuous variables were expressed as mean ± SD and compared using one-way ANOVA with post hoc testing. Categorical data were compared using the Chi-square test. P <0.05 was considered statistically significant. Results: Group C (epidural bupivacaine) demonstrated the highest QoR-15 scores across all postoperative days ( P < 0.001), followed by Groups B, D and A. Group C also exhibited superior pain control, faster recovery and fewer side effects. ( P < 0.05). Conclusion: Epidural non-opioid analgesia offers superior quality of recovery in oncological abdominal surgeries. Opioid-sparing regimens can improve outcomes and reduce healthcare burdens.