Background. Optimal management of post-operative pain is known to influence both short term and long term results of an operation.Post operation, pain results and warrants post-operative epidural pain management. There are two ways of administering drugs via the epidural catheter, which is the continuous epidural infusion (CEI) and the intermittent epidural bolus.Until recently, several studies have been conducted to compare the efficacy between CEI and IEB technique in management of acute post-operative pain but the results remain controversial. Objective.This study is aimed to compare the efficacy of continuous 2cc/hour for 5 hours epidural infusion versus intermittent 10cc/5 hours epidural bolus technique using Bupivacaine 0.125% with additional Fentanyl 1mcg/cc in post-operative acute pain management. Method. Forty-eight patients whom underwent gynaecologic operation received postoperative epidural analgesia. The patients were randomly divided into two groups. In the IEB group (n = 24), patients received a bolus of 10 cc 0.125% Bupivacainewith additional Fentanyl 1 mcg / cc every 5 hours. In the EIK group (n = 24), patients received the same regiment but is given in a continuous infusion at 2 cc / hour. Analgesia is evaluated using the Numeric Rating Scale (NRS) every hour for 24 hours post-operation. NRS value of 0-2 is accepted as positive efficacy whilst 3-10 is negative efficacy. Hemodynamic changes were also recorded. Results: There were significantly more positive efficacy in the CEI group than IEB group at the 4th, 5th, 10th, 14th, 15th, 19th, and 20th hour whereby (p 0,000 at the 5th, 10th, 15th, and 20th hour andp 0,002 at the 4th, 9th, 14th, nad 19th hour. The mean efficacy in 24 hours is significantly greater in the CEI group than IEB group ( p 0,005 for positive efficacy between CEI and IEB (p<0,01)). Conclusion : The usage of Bupivacaine 0.125% added with Fentanyl 1 mcg/cc with CEI 2cc/hour technique is more efficacious than IEB 10 cc/5 hourstechnique in the management of post-operative acute pain.

Background. Optimal management of post-operative pain is known to influence both short term and long term results of an operation.Post operation, pain results and warrants post-operative epidural pain management. There are two ways of administering drugs via the epidural catheter, which is the continuous epidural infusion (CEI) and the intermittent epidural bolus.Until recently, several studies have been conducted to compare the efficacy between CEI and IEB technique in management of acute post-operative pain but the results remain controversial. Objective.This study is aimed to compare the efficacy of continuous 2cc/hour for 5 hours epidural infusion versus intermittent 10cc/5 hours epidural bolus technique using Bupivacaine 0.125% with additional Fentanyl 1mcg/cc in post-operative acute pain management. Method. Forty-eight patients whom underwent gynaecologic operation received postoperative epidural analgesia. The patients were randomly divided into two groups. In the IEB group (n = 24), patients received a bolus of 10 cc 0.125% Bupivacainewith additional Fentanyl 1 mcg / cc every 5 hours. In the EIK group (n = 24), patients received the same regiment but is given in a continuous infusion at 2 cc / hour. Analgesia is evaluated using the Numeric Rating Scale (NRS) every hour for 24 hours post-operation. NRS value of 0-2 is accepted as positive efficacy whilst 3-10 is negative efficacy. Hemodynamic changes were also recorded. Results: There were significantly more positive efficacy in the CEI group than IEB group at the 4th, 5th, 10th, 14th, 15th, 19th, and 20th hour whereby (p 0,000 at the 5th, 10th, 15th, and 20th hour andp 0,002 at the 4th, 9th, 14th, nad 19th hour. The mean efficacy in 24 hours is significantly greater in the CEI group than IEB group ( p 0,005 for positive efficacy between CEI and IEB (p<0,01)). Conclusion : The usage of Bupivacaine 0.125% added with Fentanyl 1 mcg/cc with CEI 2cc/hour technique is more efficacious than IEB 10 cc/5 hourstechnique in the management of post-operative acute pain.

Kata Kunci : analgesia, nyeri akut post operasi, epidural infus kontinyu, epidural bolus intermiten, NRS