Perbandingan Efektivitas Kombinasi Fentanyl–Paracetamol dan Fentanyl–Ketorolac terhadap Numerical Rating Scale (NRS) Post Operasi Seksio Sesarea

Indonesia

  • Andy H Faculty of Medicine Universitas Sebelas Maret Solo
  • Sugeng Budi Santoso Faculty of Medicine Universitas Sebelas Maret Solo
  • RTH Supraptomo
Keywords: fentanyl, ketorolac, nyeri pasca seksio sesarea, paracetamol, pain after cesarean section

Abstract

Latar Belakang: Nyeri post operasi seksio sesarea merupakan nyeri sedang berat dengan intensitas akut. Saat ini terdapat dua kombinasi obat anti nyeri yang umum digunakan untuk mengatasi nyeri post operasi seksio sesarea yaitu kombinasi parasetamol-fentanyl serta kombinasi ketorolac-fentanyl. Interaksi kedua obat tersebut dapat menurunkan ambang nyeri yang dapat kita periksa dengan skor Numerical Rating Scale (NRS).
Tujuan: Untuk mengetahui adanya perbedaan efektivitas antara pemberian kombinasi parasetamol-fentanyl dengan ketorolac-fentanyl dalam mengatasi nyeri post operasi seksio sesarea.
Subjek dan Metode: Penelitian eksperimental dengan pendekatan uji klinis menggunakan 30 subjek pasien hamil dengan umur 20-40 tahun dengan status fisik ASA I-II yang akan menjalani operasi seksio sesarea dengan spinal anestesi lidocain 5% hiperbarik. Grup pertama diberikan 1000mg paracetamol dan 0,3mcg/kg/jam fentanyl intravena sebagai analgesik. Grup ke 2 diberikan ketorolac 30mg dan fentanyl o,3mcg/kg/jamPada penelitian ini dilakukan analisis univariat dan bivariat.
Hasil: Hasil uji beda terhadap karakteristik subyek penelitian didapatkan pada kelompok parasetamol dan fentanyl terdapat perbedaan yang signifikan pada post operasi dengan nilai p=0,005 (p<0,05), pada ketorolac dan fentanyl terdapat perbedaan yang signifikan post operasi dengan nilai p=0,023 (p<0,05) d
Simpulan: Kombinasi parasetamol fentanyl lebih efektif dibandingkan dengan ketorolac fentanyl.

 

The Comparison of the Effectiveness of Combination Fentanyl-Paracetamol with Fentanyl–Ketorolac on Numerical Rating Scale (NRS) Post Caesarean Section

Abstract

Background: Postoperative cesarean section pain is moderate-to-severe pain with acute intensity. There are two common anti-pain drug combinations used to treat post-cesarean section pain, namely the parasetamol-fentanyl combination and the ketorolac-fentanyl combination. The interaction of the two drugs can lower the pain threshold which we can check with the Numerical Rating Scale (NRS) score.
Objective: To determine the difference in effectiveness between the combination of parasetamol-fentanyl and ketorolac-fentanyl in dealing with post-cesarean section surgery pain.
Subject and Method: This study is an experimental study with a clinical trial approach using 30 subjects of pregnant patients aged 20-40 years with ASA I-II physical status who will undergo cesarean section surgery with hyperbaric 5% lidocaine spinal anesthesia. The first group were given 1000 mg parasetamol and 0.3 mcg/kg/h fentanyl intravenous as analgesics. The second group were given ketorolac 30 mg and fentanyl 0.3 mcg/kg/h intravenously. In this study, univariate and bivariate analyzes were performed.
Results: The results of different tests on the characteristics of research subjects were found in the paracetamol and fentanyl groups, there was a significant difference in the post-operation with a value of p = 0.005 (p <0.05), in ketorolac and fentanyl there was a significant difference post-surgery with a value of p = 0.023 (p <0.05) where the paracetamol and fentanyl groups with NRS scores tended to fall, and the ketorolac and fentanyl groups with NRS scores tended to increase.
Conclusion: The combination of parasetamol and fentanyl was more effective than ketorolac and fentanyl.

Author Biographies

Andy H, Faculty of Medicine Universitas Sebelas Maret Solo

Departement Anesthesiology and Intensive care General Hospital Dr. Moewardi Solo

Sugeng Budi Santoso, Faculty of Medicine Universitas Sebelas Maret Solo

Department Anesthesiology and Intensive Care General Hospital Dr. Moewardi Solo

References

Suryati T. Percentage of Sectio Caesaria in Indonesia is Passad the Maximum Standard, is it in accordance to Medical Indication. Bul Penelit Sitem Kesehatan Pus Teknol Interv Kesehatan Masyarakat, Kebijak Kesehatan dan Pemberdaya Masyarakat, Badan Penelit dan Pengemb Kesehatan, Kementeri Kesehat RI. 2012.

Hutchison RW. Challenges in acute post operative pain management. Am J Heal Syst Pharm. 2007;15(64):2–5.

Egan H. Pharmacology and Physiology For Anesthesia. 2nd ed. Toronto: Saunders, 2018, 774-79.

Jordan S, White J. Non-steroidal anti-inflammatory drugs. Clin Issues Nurs Stand. 20001;15(23): 45–52.

Butterworth IV JF, Mackey DC, Wasnick JD. Morgan & Mikhail’s Clinical Anesthesiology, 5th ed. Morgan & Mikhail’s Clinical Anesthesiology. New York: Mc Graw Hill; 2013, 309–41.

WHO. WHO Pain Relief Ladder for cancer pain relief. [Internet]. 2015 [cited 2015 Sep 14]. Available from: www.who.int/cancer/palliative/painladder/en/

Wiknjosastro H. Ilmu Bedah Kebidanan. Jakarta: PT Bina Pustaka Sarwono Prawirohardjo; 2010, 56–9.

Haydar B. Stoelting’S Pharmacology and physiology in anesthetic practice [Internet]. 5th edition. University of Michigan; 2015, 1445. Available from: https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2294677.

Wilmana P, Gunawan S. Analgetik Antipiretik, Analgesik Antiinflamasi Non Steroid dan Obat Gangguan Sendi Lainnya. Dalam: Farmakologi dan Terapi. Jakarta: Balai Penerbit FKUI; 2009, 204.

Katzung B. Farmakologi Dasar dan Klinik. Alih bahasa, staf dosen farmakologi fakultas kedokteran UNSRI. 8th ed. Agoes A, editor. Jakarta: EGC; 2011. 559–77.

Published
2020-09-17
Section
Articles