Perbandingan Bupivakain 0,25% dengan Kombinasi Bupivakain 0,25% dan Deksametason 8 mg pada Blok Transversus Abdominis Plane dengan Panduan Ultrasonografi sebagai Analgesia Pascahisterektomi

Eddo Alan Delis, Erwin Pradian, Dedi Fitri Yadi

Abstract


Analgesia dinding abdomen anterior dan lateral dapat dilakukan dengan blok transversus abdominis plane (TAP). Penelitian ini bertujuan menilai waktu kebutuhan analgesik pertama dan skor nyeri 2, 4, 6, 12, 24 jam pascahisterektomi antara bupivakain 0,25% dengan kombinasi bupivakain 0,25% dan deksametason 8 mg pada blok TAP. Penelitian menggunakan uji klinis acak terkontrol buta tunggal, dilakukan di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada bulan Oktober–Desember 2017. Pasien dibagi menjadi grup bupivakain 0,25% (grup B, n=20) dan grup kombinasi bupivakain 0,25% deksametason 8 mg (grup BD, n=20). Uji statistik menggunakan uji-t berpasangan, Uji Wilcoxon, dan uji chi-square. Hasil penelitian mengungkapkan waktu kebutuhan analgesik pertama lebih lama pada grup BD (866,45±98,11 menit) dibanding dengan grup B (352,75±43,32 menit) dengan perbedaan signifikan (p<0,05). Median skor nyeri  pascahisterektomi grup BD pada 4 jam (1), 6 jam (2), 12 jam (2), dan 24 jam (2) lebih rendah dibanding dengan grup B dengan median skor nyeri 4 jam (2), 6 jam (3), 12 jam (4), dan 24 jam (3), dengan perbedaan signifikan (p<0,05). Simpulan penelitian ini adalah kombinasi bupivakain 0,25% dan deksametason 8 mg pada blok TAP menghasilkan waktu kebutuhan analgesik pertama lebih lama dan skor nyeri pascahisterektomi lebih rendah dibanding dengan bupivakain 0,25%.

Kata kunci: Blok transversus abdominis plane, deksametason, skor nyeri, waktu kebutuhan analgesik pertama


Comparison between 0.25% Bupivacaine  and Combination of 0.25% Bupivacaine and 8 mg Dexamethasone  on Transversus Abdominis Plane Block Ultrasound-guided as Post- Hysterectomy Analgesia

 Analgesia for  anterior and lateral abdominal walls can be provided through transversus abdominis plane (TAP) block. This study aimed to evaluate the timing of first analgesic requirement and post- hysterectomy pain scores at 2, 4, 12, 24 hours between 0.25% bupivacaine and combination of 0.25% bupivacaine and 8 mg dexamethasone on TAP block. This was a randomized single-blind controlled trial study on patients Dr. Hasan Sadikin Hospital (RSHS) Bandung in the period of October–December 2017. Patients were randomly divided into 0.25% bupivacaine (B group, n=20) and o0.25% bupivacaine 8 mg dexamethasone combination (BD group, n=20). Statistical test was performed using paired t test, Wilcoxon test, and chi-square test. It was revealed that the time to first analgesic requirement was longer in BD group (866.45±98.11 minutes) than in B group (352.75±43.32 minutes) with a significant difference (p<0.05). The post-hysterectomy pain score medians in BD group at 4 hours (1), 6 hours (2), 12 hours (2), and 24 hours (2) were lower than those of B group with a significant difference (p<0.05). Therefore, 0.25% bupivacaine and 8 mg dexamethasone combination for ultrasound-guided TAP block presents longer time to first analgesic requirement and lower pain score compared to  0.25%. bupivacaine

Key words:  Dexamethasone, pain  score, time  to  first  analgesic requirement,   transversus abdominis plane  block

 


Keywords


Blok transversus abdominis plane, deksametason, skor nyeri, waktu kebutuhan analgesik pertama

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DOI: http://dx.doi.org/10.15851/jap.v6n2.1240

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