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Application for ESRA Abstract Prizes:Background and Aims Regional anaesthesia (RA) can be utilised to reduce post-operative pain following transthoracic oesophagectomy. Thoracic epidurals may cause a sympathetic block which contributes to post-operative hypotension and increased vasopressor use.1 Alternative regional anaesthetic techniques include paravertebral (PVB) and erector spinae plane (ESP) catheters. We aimed to investigate if different analgesic options influence vasoconstrictor requirements and length of intensive care unit (ICU) stay after oesophagectomy.Methods This was a single site retrospective observational study. Data were collected on all patients admitted to ICU following transthoracic oesophagectomy between 2018–2023 inclusive. All data were anonymised and stored on a secure spreadsheet (Excel). Patients were grouped by analgesic modality: intrathecal morphine (ITM) only; epidural; or non-epidural RA technique. Groups were compared in terms of total noradrenaline requirements and length of ICU stay using Kruskal-Wallis tests (R Studio).Results We identified 58 patients who received either intrathecal morphine (ITM) only (n=16); PVB (n=19); ESP (n=7); or epidural block (n=16). Median (Q1-Q3) total noradrenaline requirement was 2.6 mg (0.0–10.8) and length of ICU stay 8.0 days (6.0–11.7) for all groups combined. Median (Q1-Q3) noradrenaline requirements (ITM 5.5 (0.0–13.6) mg, ESP/PVB 3.7 (0.0–18.5) mg, epidural 0.85 (0.0–8.9) mg) and length of ICU stay (ITM 7.7 (6.0–10.0) days, ESP/PVB 8.8 (6.5–13.3) days, epidural 7.5 (5.8–14.5) days) were similar for all 3 groups (p = 0.61 and 0.66 respectively).Conclusions Our results show no clear influence of analgesic technique on post-operative noradrenaline requirements or length of ICU stay. Post-operative hypotension in patients admitted to ICU following oesophagectomy is likely to be multifactorial.