Comparison of Intermittent Bolus and Continuous Infusion Epidural for Postoperative Pain Management in Abdominal Surgery Patients

Taufiq Agus Siswagama, Aswoco Andyk Asmoro, Houdini Pradanawan Subagyo, Buyung Hartiyo Laksono

Abstract


Background: Abdominal surgery is one type of surgery with a high postoperative pain score. The use of epidural techniques as post-abdominal pain management has been widely recommended. The epidural analgesia technique can be done using continuous infusions or intermittent boluses. Several studies that have been conducted on the comparison of the two techniques have not yielded definite results as to which one is superior.

Objective: To determine the comparison of the effectiveness of continuous infusion epidural with intermittent bolus epidural  as a postoperative analgesic in patients undergoing abdominal surgery.

Method: Observational analysis of cross sectional approach. The data was taken retrospectively from medical records for the period of July 2022 – December 2022 and analyzed using the SPSS application.

Results: The research subjects were 90 patients. The results of the comparative test of postoperative pain score when stationary and mobile between continuous infusion epidural and intermittent bolus epidural  had significant results at 12 hours, 24 hours and 36 hours postoperatively (p value < 0.05). Meanwhile, the results of the comparative test of postoperative pain score during daim and movement between continuous infusion epidural and intermittent bolus epidural  had insignificant results at 48 hours, 60 hours, 72 hours and 84 hours postoperatively.

Conclusions: Continuous infusion epidural had better effectiveness than intermittent bolus epidural  in terms of pain score at rest and movement at 12 hours, 24 hours and 36 hours postoperatively, but did not have significant results in terms of pain score at rest and movement at 48 hours, 60 hours, 72 hours and 84 hours postoperatively.


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