Background: Numerous perioperative analgesia techniques for upper gastrointestinal (UGI) surgery are available, but the optimal approach remains uncertain. This network meta-analysis (NMA) evaluates local and regional techniques in terms of postoperative pain and opiate consumption using randomised trials (RCT) following open UGI surgery. Methodology: A Bayesian NMA analysed MEDLINE, Embase, PubMed, and Cochrane CENTRAL databases from January 2010 until November 2023. The primary outcome was postoperative pain intensity at 24 hours. Secondary analyses included cumulative opioid consumption, nausea and/or vomiting and length of hospital stay. Results: Fifty-three RCTs (n=4,207 patients) were included, assessing epidural analgesia, intrathecal morphine, continuous wound infusion, local wound infiltration, paravertebral block, transversus abdominis plane block, and systemic opiates. Epidural analgesia was the most effective for reducing 24-hour postoperative pain (Mean Difference [MD] -0.976; Credible Interval [CrI] -0.558,-1.401)) and opiate consumption (MD -24.717; CrI -16.541,-33.355). At 48-hours, epidural analgesia was associated with postoperative pain intensity (MD -0.645; CrI -0.141,-1.148) and opioid consumption (MD -21.008; CrI -8.533,-33.658). Transversus abdominis plane blocks at 24-hours reduced pain (MD -0.730; CrI -1.229,-0.223) and opioid consumption (MD -13.048; CrI, -22.033,-4.314). Continuous wound infusion (MD -14.989; CrI -25.975,-4.066) and local wound infiltration (MD -30.381; CrI -46.045,-15.470) showed significant opioid-sparing benefits at 24 hours. Conclusion: Epidural analgesia is the most effective technique for reducing pain and opioid consumption in early postoperative care following UGI surgery.