Perbandingan Intensitas Nyeri dan Kadar Prostaglandin Kombinasi Tramadol dan Deksketoprofen dengan Tramadol dan Parasetamol Intravena pada Pasien Bedah Ortopedi Ekstremitas Bawah

Clara Valentia Josephine, Muhammad Ramli Ahmad, Hisbullah Hisbullah, Abdul Wahab

Abstract


Analgesia multimodal adalah prinsip manajemen nyeri pascaoperasi. Penelitian ini merupakan uji klinis rancangan acak tersamar ganda. Tujuan penelitian ini membandingkan efek kombinasi analgesik tramadol dan deksketoprofen dengan tramadol dan parasetamol terhadap intensitas nyeri dan kadar prostaglandin (PGE2) di RSUP Dr. Wahidin Sudirohusodo serta Rumah Sakit Jejaring di Makassar pada bulan Juli–September 2018. Empat puluh enam pasien ASA PS I dan II yang menjalani operasi ortopedi ekstremitas bawah dibagi menjadi dua kelompok. Kelompok D adalah pasien yang menerima 50 mg tramadol dengan 50 mg deksketoprofen dan kelompok P adalah pasien yang menerima 50 mg tramadol dengan 1.000 mg parasetamol intravena. PGE2 dan intensitas nyeri dicatat selama penutupan kulit sebelum pemberian obat 8 dan 16 jam sesudahnya. Data dianalisis menggunakan Uji Mann-Whitney U dan paired t-test yang sesuai. Numeric rating scale (NRS) kelompok tramadol dan deksketoprofen lebih rendah dibanding dengan kelompok tramadol dan parasetamol dengan perbedaan bermakna (p<0,05). Kadar PGE2 menurun pada kelompok tramadol dan deksketoprofen (T1–T2 p=0,009 dan T0–T2 p=0,01), sedangkan kadar PGE2 pada kelompok tramadol dan parasetamol meningkat (T2–T1 p=0,227 dan T0–T2 p=0,706). Simpulan, kombinasi tramadol dan deksketoprofen mengurangi tingkat PGE2 dan intensitas nyeri dibanding dengan kombinasi tramadol dan parasetamol.

 


Keywords


Deksketoprofen; parasetamol; PGE2; tramadol

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DOI: https://doi.org/10.15851/jap.v7n2.1691


 

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