The Association Between Analgesia Gap and Type of Surgery, Analgesic Drugs, and Timing of Analgesic Administration: What Do We Know?

BACKGROUND: Inadequate postoperative pain management poses unique challenges for anesthesiologists. The transition from epidural analgesia to other analgesic drugs has its own challenges. Increasing pain during this period is defined as analgesia gap. OBJECTIVES: This study aimed at determining the incidence of analgesia gap and its associated factors, such as type of surgery, analgesic drugs, and timing of analgesic administration. METHODS: This was a prospective cohort among acute pain service patients at a tertiary hospital from July to October 2018. There were 220 subjects included in this study. All subjects were scheduled for elective surgery with epidural analgesia. Following last epidural regimen administration, the pain scale was assessed using VAS. If the patient had VAS more than four, then they were classified as having analgesia gap. Type of surgery, type of analgesic drugs, and timing of drugs administration were measured as the associating factors. RESULTS: The incidence of analgesia gap in this tertiary hospital was 26.6%. Type of surgery was not significantly associated with the incidence of analgesia gap (P = 0.057). However, type of analgesic drugs and timing of analgesic administration were related to incidence of analgesic gap (P = 0.016 and P < 0.001). CONCLUSIONS: The incidence of analgesia gap in this study was 26.6%. Type of analgesic drugs and timing of analgesic administration had a significant association with the incidence of analgesia gap. However, type of surgery did not have a significant association with the incidence of analgesia gap.