Perbandingan Tramadol dengan Lidokain untuk Mengurangi Derajat Nyeri Penyuntikan Propofol

Oka Endarto, Ruli Herman Sitanggang, Budiana Rismawan

Abstract


Propofol adalah obat anestesi intravena yang sering digunakan untuk tidakan medis karena memiliki onset dan durasi cepat. Nyeri saat penyuntikan propofol merupakan permasalahan yang sering dikeluhkan pasien dan berbagai metode telah dilakukan untuk mengurangi derajat nyeri penyuntikan propofol, namun masih didapatkan nyeri. Lidokain menjadi standar emas untuk mengurangi derajat nyeri penyuntikan propofol, tetapi masih memiliki efek samping seperti penekanan fungsi jantung sehingga dipilih tramadol yang tidak menekan fungsi jantung dan dapat menurunkan kebutuhan obat antinyeri selama maupun setelah operasi. Penelitian ini bertujuan membandingkan pemberian tramadol dengan lidokain untuk mengurangi derajat nyeri penyuntikan propofol. Metode penelitian menggunakan uji klinis acak buta tunggal terhadap 60 pasien yang menjalani operasi elektif. Pasien dibagi menjadi 2 kelompok, yaitu perlakuan tramadol (kelompok T) dan perlakuan lidokain (kelompok L) disertai pembendungan vena permukaan menggunakan tourniquet, kemudian diberikan tramadol atau lidokain. Setelah 1 menit tourniquet dilepaskan dan diikuti dengan penyuntikan ¼ dosis total propofol untuk induksi selama 5 detik, lalu dilakukan penilaian derajat nyeri menggunakan verbal rating score. Hasil penelitian menunjukkan penurunan derajat nyeri penyuntikan propofol pada kedua kelompok dan tidak terdapat perbedaan bermakna  (p>0,05), namun melalui uji statistik dengan tingkat kepercayaan sebesar 95% menyatakan tramadol memiliki risiko relatif kemungkinan terjadi nyeri ringan lebih kecil dibanding dengan lidokain menurunkan derajat nyeri penyuntikan propofol. Simpulan, Tramadol memiliki kekuatan yang sama dengan lidokain dalam menurunkan derajat nyeri penyuntikan propofol.

Comparison between Tramadol and Lidocaine in Reducing Pain Triggered by Propofol Injection

Propofol is a commonly used intravenous anesthetics in medical procedure. Pain during propofol injection is a commonly reported adverse effect of this injection. Various methods have been proposed to reduce pain but often fail. Lidocaine is the gold standard for reducing pain during injection of propofol but has a suppressive effect on the heart. Tramadol does not have a suppressive effect and reduce the need for anti-pain medication during and after surgery thereforeTramadol is chosen for this purpose. This study aimed to compare the administration of tramadol and lidocaine to reduce the level of pain during propofol injection. This was a single blind randomized clinical trial on 60 patients underwent elective surgery. Patients were divided into 2 groups: the first group received tramadol (group T) and the second group received lidocaine (group L). Tourniquet was used on each patient before injection of tramadol or lidocaine was given and it was removed after 1 minute. Pain severity was assessed 5 seconds after propofol injection using the verbal rating score. This study discovered that pain during propofol injection was reduced with the use of tramadol and lidocaine without significant difference between the two (p>0.05). However, tramadol has a lower probability of mild pain than lidocaine with interval confidence 95%. In conclusion, tramadol has the same potential as lidocaine in reducing the level of pain related to propofol injection.

 


Keywords


Lidokain; nyeri; propofol; tramadol; verbal rating score

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DOI: https://doi.org/10.15851/jap.v7n2.1740


 

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