Background: Epidural analgesia is the technique of choice to reduce acute pain caused by surgery. The aim of this study are to find if there any difference in post-operative pain intensity between patients that undergo continuous and intermitten epidural analgesia.
Methods: This study is an experimental, single blind randomised controlled trial. Samples of the study are 17 to 60 years old patients with ASA physical status I-II and BMI of 18,5-25 kgs/m2 that undergone elective or emergency surgery on abdomen or extremities using epidural analgesia techniques. 20 samples randomisedly picked at the end of surgery to each study group which is continuous epidural analgesia group (I) and intermitten epidural analgesia group (II). 8 ml of bupivacaine 0,125% are given by bolus via epidural catheter in each group at the end of surgery. In the continuous epidural analgesia group, bupivacaine 0,125% are given continuously at the rate of 2 ml/hour via epidural catheter for the first 24 hours after surgery. In the intermitten epidural analgesia group, 8 ml of bupivacaine 0,125% are given intermittenly every 4 hour via epidural catheter for the first 24 hours after surgery. Pain intensity in each group are evaluated and documented every 4 hours for the first 24 hours after surgery using Verbal Numerical Analogue Scale (VNAS). Data were then collected and analysed with mann-whitney using SPSS 16.0 (p<0,05 means there are statistical difference between study group).
Results: Group I showed better pain intensity in 4 hours after surgery, the median VNAS score was 0, compared to group II that has median VNAS score of 1 (p=0,009). Group II showed better pain intensity in the 20th to 24th hours after surgery, with the median VNAS score of 1, compared to group I that has median VNAS score of 2 (p=0,020 at the 20th hours after surgery and p=0,000 at the 24th hours after surgery). There are no difference in median VNAS score between two groups at the 8th, 12th, and 16th hours after surgery (p=0,114; p=0,758; p=0,369). Median VNAS score of group II was 1 at every 4 hours evaluation in the first 24 hours after surgery
Conclutions: intermitten epidural analgesia are better than continuous epidural analgesia in controlling post operative acute pain. Intermitten epidural analgesia are very stable to control post-operative acute pain.