Descriptive Analysis of Epidural Analgesia in Postoperative Acute Pain Service
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Abstract
Background: Epidural analgesia (EA) is an effective and safe approach in postoperative pain management performed widely with rare complications and high treatment outcome satisfaction. This literature presents epidural analgesia in postoperative acute pain service (APS), hence provides an epidemiological database and describes current trends in anesthetic practice predominantly in our hospital.
Methods: We performed retrospective analyses of all postoperative subjects with EA at Sanglah Public General Hospital Bali between April 2017 to 2018. The parameters being evaluated were baseline characteristic, diagnosis, type of surgery, anesthetic technique, drugs used in EA, multimodal analgesia used accompanying EA, duration of EA, as well as diagnosis categories, which divided into gastrointestinal, genitourinary, lower extremity, obstetrics-gynecology, spine, and thoracic.
Results: A total of 460 subjects were given postoperative EA, with slight female predominance (50.9%), mean age 51.6 years old. The majority of EA was done in lower extremity procedures (51.9%), with femur fracture was the most common diagnosis (n=105). The combination of local anesthetic and morphine was the most common drugs used in EA (92.8%). For 86% of subjects received multimodal analgesia instead of using EA only. Paracetamol and EA were accounted for 312 subjects, while others used NSAIDs or opioids. The mean duration of postoperative EA was three days, with a significant correlation between diagnosis and duration of EA p= 0.036. LA and morphine were the combination of choice for gastrointestinal, spine, and thoracotomy procedures p=0.005 (p <0.05).
Conclusion: This one-year statistical analysis reveals that EA is applicable in many different procedures while demonstrating the use of multimodal analgesia in our hospital's APS.
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