Perbandingan Efek Infus Kontinyu Fentanil 0,7 mcg/Kgbb/Jam dengan Lidokain 1,5 Mg/Kgbb/Jam terhadap Kualitas Pemulihan Paska Anestesia Umum dengan Skoring Qor-40 pada Operasi Laparatomi

Abstract

Background: Postoperative pain following laparotomy remains a clinical issue that affects patients’ recovery quality. Inadequate analgesia may lead to complications, increased opioid consumption, and reduced quality of life. Fentanyl and lidocaine are commonly used agents but differ in their side effect profiles and effectiveness. The Quality of Recovery-40 (QoR-40) score is a validated instrument to comprehensively assess postoperative recovery, covering physical, psychological, comfort, and social functioning aspects. Comparative research on the effects of these two agents on postoperative recovery quality under general anesthesia remains limited. Objective: To compare the effects of continuous infusion of fentanyl (0.7 mcg/kg/h) and lidocaine (1.5 mg/kg/h) on postoperative recovery quality in laparotomy patients under general anesthesia using the QoR-40 score. Methods: This study was a double-blind randomized controlled clinical trial involving 40 postoperative laparotomy patients at Haji Adam Malik Hospital, Medan. Patients were divided into two groups receiving either fentanyl or lidocaine infusions postoperatively. Recovery was evaluated 24 hours post-surgery using the QoR-40 and VAS scores, with monitoring of side effects and rescue analgesia requirements. Results: Fentanyl demonstrated superior outcomes compared to lidocaine in terms of comfort (49.35 ± 5.696 vs. 32.55 ± 12.479) and pain control (59.55 ± 5.934 vs. 42.2 ± 13.364), with statistically significant differences (p = 0.00). Additionally, the fentanyl group required fewer and delayed rescue analgesics (p = 0.000). While scores in emotional state, support, and independence showed no significant differences (p > 0.05), fentanyl overall resulted in better postoperative recovery, reflected by higher QoR-40 scores (p = 0.001). Conclusion: Fentanyl is more effective than lidocaine in improving the quality of postoperative recovery under general anesthesia in laparotomy patients based on QoR-40 scoring.