Update Procedure-Specific Postoperative Pain Management (PROSPECT) pada Seksio Sesarea dengan Konsep ERACS
Abstract
Konsep penggunaan Enhanced Recovery After Caesarean Section (ERACS) pada seksio sesarea (SC) semakin berkembang sehingga pentingnya analgesia postoperatif untuk memastikan pemulihan optimal serta prognosis yang baik terkait fungsi dan komplikasi. Data terbaru menunjukkan bahwa penatalaksanaan nyeri yang buruk serta pengalaman nyeri yang “tidak menyenangkan” dihubungkan komplikasi postoperatif, termasuk nyeri pasca SC dapat mempengaruhi pemulihan pascaoperasi dan kepuasan pasien serta keberhasilan menyusui dan ikatan ibu-anak. Selain itu, terapi nyeri akut suboptimal dapat meningkatkan risiko terjadinya nyeri postoperatif kronik. Teknik baru telah dikembangkan untuk mengatasi nyeri setelah operasi SC, seperti blok quadratus lumborum, anestesi lokal lepas lambat, dan pendekatan nonfarmakologis. Selain itu, dalam dekade terakhir, perhatian telah bergeser untuk mengurangi penggunaan opioid dan menerapkan protokol untuk pemulihan yang lebih baik setelah operasi SC. Oleh karena itu, dibutuhkan tinjauan sistematis terbaru tentang intervensi analgesik untuk manajemen nyeri setelah operasi SC elektif dilakukan dengan menggunakan anestesi neuraksial. Selain itu, dianggap perlu untuk menilai kembali rekomendasi untuk menyelaraskannya dengan pendekatan Procedure-Speciific Pain Management (PROSPECT) yang diperbarui yang mempertimbangkan relevansi klinis dan efektivitas klinis saat ini dengan menyeimbangkan invasi dari intervensi analgesik dan tingkat nyeri setelah operasi SC, serta menyeimbangkan efikasi dan efek samping.
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Jurnal Anestesi Obstetri Indonesia
