Table 1 Inclusion and exclusion criteria

• Patients >18 years of age

• Contraindication to epidural analgesia: for example, coagulopathy, local infection, systemic sepsis, severe aortic stenosis

• Planned major abdominal surgery including major colorectal resections, pancreaticoduodenectomy and radical cystectomy

• Consent refused for either TEA or RSC

• Planned open midline surgical incision

• Non-English speaker

• Included in the ERP

• Ano-rectal excision: for example, pan-proctocolectomy or abdomino-perineal resection.

• Willing and able to give consent

• Planned transverse or oblique incisional approach

• ASA (American Society of Anesthesiologists) 1 to 3

• Allergy to local anaesthetic drugs or opiates

• Opiate tolerance

• Pre-existing chronic abdominal pain

• Extensive existing midline abdominal scarring