Background: Postoperative recovery quality is a critical measure of anesthetic effectiveness, particularly in major surgeries such as laparotomy. Both fentanyl and lidocaine are used in multimodal analgesia, but their comparative efficacy on recovery quality remains underexplored.Objectives: To evaluate and compare the impact of continuous intravenous infusions of fentanyl as well as lidocaine on the quality of postoperative recovery in laparotomy patients undergoing general anesthesia, utilizing the quality of recovery-40 (QoR-40) score as the evaluation instrument.Methods: This double-blind randomized controlled trial (RCT) included 40 patients undergoing laparotomy at Adam Malik Hospital, Medan. Subjects were randomly allocated to receive either fentanyl (0.7 mcg/kg/h) or lidocaine (1.5 mg/kg/h) infusion postoperatively. QoR-40 scores were assessed 24 hours post-surgery. Pain scores and rescue analgesia requirements were also evaluated.Results: Subjects in the fentanyl group had substantially higher QoR-40 scores (173.35 ± 41.764) than those in the lidocaine group (148.95 ± 25.362; p = 0.0001). Fentanyl was superior in comfort and pain control. Rescue analgesia was needed less frequently and later in the fentanyl group (p = 0.0001).Conclusion: Fentanyl infusion substantially improved postoperative recovery quality more effectively than lidocaine in patients undergoing laparotomy, particularly in pain management and comfort.
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