Efektivitas Analgesik 24 Jam Pascaoperasi Elektif di RSUP Dr. Hasan Sadikin Bandung Tahun 2017

Dita Aryanti Prabandari, Indriasari Indriasari, Tinni Trihartini Maskoen

Abstract


Nyeri akut pascaoperasi masih merupakan permasalahan dalam pelayanan kesehatan di seluruh dunia. Hampir 50% pasien pascaoperasi elektif mengalami nyeri yang berujung terhadap peningkatan kejadian nyeri kronik dan penurunan kepuasan pasien terhadap pelayanan kesehatan. Penelitian ini bertujuan memberikan gambaran mengenai analgesik yang digunakan di RSUP Dr. Hasan Sadikin Bandung dan efektivitasnya terhadap nyeri pascaoperasi. Penelitian ini menggunakan metode deskriptif observasional prospektif cross-sectional yang dilakukan pada pasien usia 18–65 tahun dengan status fisik American Society of Anaesthesiologist (ASA) kelas I–III di ruang perawatan pada jam ke-24 pascaoperasi selama tahun 2017 sebanyak 476 pasien. Subjek penelitian dikelompokkan berdasar atas jenis operasi yang menyebabkan nyeri ringan, sedang dan berat. Jenis analgesik pascaoperasi yang digunakan dan skala nyeri menggunakan numeric rating scale (NRS) dicatat. Efektif bila skala nyeri menggunakan NRS pada jam ke-24 pascaoperasi <4 dan tidak efektif bila NRS ≥4. Hasil penelitian didapatkan jenis analgesik terbanyak yang digunakan pada pasien pascaoperasi elektif adalah kombinasi petidin dan ketorolak i.v. dan derajat nyeri pada jam ke-24 pascaoperasi elektif yang dialami pasien adalah nyeri ringan NRS 1–3 (57,8%), nyeri sedang NRS 4–6 (26,9%), dan nyeri berat NRS 7–10 (2,7%). Simpulan penelitian ini adalah efektivitas analgesik pascaoperasi di RSUP Dr. Hasan Sadikin Bandung masih belum baik karena masih terdapat sepertiga pasien mengalami nyeri NRS ≥4 dari target rumah sakit 100% bebas nyeri.

Kata kunci: Analgesik pascaoperasi, derajat nyeri pascaoperasi, efektivitas analgesik pascaoperasi

 

Effectiveness of Analgesics 24 Hours Post-Post-Elective Surgery in Dr. Hasan Sadikin General Hospital in 2017

Acute post-operative pain is still a worldwide issue in healthcare services. Nearly 50% of post-elective surgery patientspost- experience post-post-operative pain, causing increased chronic pain and decreased patient satisfaction towards healthcare services. This study aimed to provide  description on the types of analgesics used in Dr,Hasan Sadikin General Hospital and their effectiveness on post-operative pain. This  was a cross-sectional descriptive observational prospective study performed on 476 patients aged 18–65 years old with a physical status American Society of Anaesthesiologist (ASA) class I–III, treated in the ward 24 hours post- surgery in 2017. Subjects were classified based on the type of surgery that induced mild, moderate, and severe pain. The types of post-operative analgesics used and post-surgery Numeric Rating Scale (NRS) were documented. Analgesics was considered effective if the 24 hour post-surgery NRS was <4 and ineffective if the NRS was ≥4. This study showed that the type of analgesicsa mostly used for post-operative pain  was the combination of pethidine and ketorolac i.v. Pain scales experienced by patients at 24 hours post- surgery were mild withNRS 1–3 (57.8%), moderate pain with NRS 4–6 (26.9%), and severe pain with NRS 7–10 (2.7%). In conclusion, the post-operative analgesics provided in Dr. Hasan Sadikin General Hospital has not met the 100% pain free target set by the hospital target because some patients still experience pain with NRS ≥4.  . Hence, the effectiveness is still not adequate.

Key words: Effectivity of post- operative analgesia, post- operative analgesia, post- operative pain scale


Keywords


Analgesik pascaoperasi, derajat nyeri pascaoperasi, efektivitas analgesik pascaoperasi

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References


Biocic M, Vidosevic D, Boric T, Boric T, Giunio L, Fabijanic D, dkk. Anesthesia and perioperative pain management during cardiac electronic device implantation. J Pain Res. 2017;10:927–32.

Garcia JB, Bonilla P, Kraychette DC, Flores FC, Perez de Valtolina ED, Guerrero C. Optimizing post-operative pain management in Latin America. Rev Bras Anestesiol. 2017;67(4):395–403.

Meissner W, Coluzzi F, Fletcher D, Huygen F, Morlion B, Neugebauer E, dkk. Improving the management of post-operative acute pain: priorities for change. Curr Med Res Opin. 2015;31(11):2131–43.

Eldor J, Kotlovker V, Orkin D. Pain free hospital – availability (24 hours) of anesthesiologists. J Anesthesiol Clin Sci. 2013;2:17. http://dx.doi.org/10.7243/2049-9752-2-17.

Kolettas A, Lazaridis G, Baka S, Mpoukovinas I, Karavasilis V, Kioumis I, dkk. Review article: postoperative pain management. J Thorac Dis. 2015;7(1):62–72.

Wandner LD, Scipio CD, Hirsh AT, Torres CA, Robinson ME. The perception of pain in others: how gender, race, and age influence pain expectation. J Pain. 2012;13(3):220–7. Doi:10.1016/j.jpain.2011.10.014.

Callister LC. Cultural influence on pain perception and behaviors. Home Health Care Management Practice. 2003;15(3):207–11.

Matijevic M, Uzarevic Z, Gvozdic V, Mikelic VM, Leovic D, Macan D. The influence of surgical experience, type of instruction given to patients and patient sex on postoperative pain intensity following lower wisdom tooth surgery. Acta Clin Croat. 2013;52:23–8.

Vivian HY, Abrishami A, Peng PWH, Wong J, Chung F. Predictors of postoperative pain and analgesic consumption a qualitative review. Anesthesiology. 2009;111:657–77.

Herbert G, Masigati, Chilonga KS. Postoperative pain management outcomes among adults treated at a tertiary hospital in Moshi, Tanzania. Tanzan J Health Res. 2014;16(1):47–53.

Woldehaimanot TE, Eshetie TC, Kerie MW. Postoperative pain management among surgically treated patients in an Ethiopian Hospital. PLos One. 2014;9(7):e102835. doi:10.1371/journal.pone.0102835. eCollection 2014.

Mowat I, Johson D. Acute pain management part 2 assesment and managmenet. Anaesth Tutorial Week-295. 2013;1(1):1–10.

Size M, Soyannwo A, Justins DM. Pain management in developing countries. journal compilation 2007 the association of anaesthetics of great britain and ireland. Anaesthesia. 2007;67(1):38–43.

Fotedar KK. WHO Ladder-Relevance in today’s world. Intern J Perioperative Ultrasound Applied Technologies. 2013;2(2):49–53.




DOI: http://dx.doi.org/10.15851/jap.v6n2.1221

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