Perbandingan Preemptive Analgesia Kombinasi Ibuprofen 75 Miligram dan Parasetamol 250 Miligram per Oral dengan Parasetamol 1 Gram per Oral terhadap Lama Analgesik Pascabedah Odontektomi

Hilmy Manuapo, Doddy Tavianto, Reza Widianto Sudjud

Abstract


Analgesik dosis tinggi dapat menimbulkan berbagai efek samping. Penggunaan kombinasi analgesik bekerja melalui mekanisme yang berbeda dan memiliki efek sinergis. Penelitian ini bertujuan mengetahui perbedaan lama analgesik antara kombinasi ibuprofen 75 mg dan parasetamol 250 mg per oral dibanding dengan parasetamol 1 g per oral terhadap nyeri pascabedah odontektomi. Penelitian eksperimental dengan uji klinis acak tersamar buta ganda terhadap 26 subjek penelitian yang menjalani odontektomi di RSUP Dr. Hasan Sadikin Bandung pada bulan Juli–Oktober 2019. Subjek dibagi menjadi kelompok P (Parasetamol) dan kelompok K (Kombinasi). Data hasil penelitian diuji secara statistik menggunakan Uji Mann-Whitney. Hasil penelitian ini didapatkan perbandingan lama analgesik pascabedah kelompok K (74,23±15,79 menit) lebih lama dibanding dengan kelompok P (50,76±17,22 menit) dengan p<0,05. Hasil skor nyeri pascabedah odontektomi pada kelompok K (2,92±0,75) lebih rendah dibanding dengan kelompok P (3,92±0,86) dengan p<0,05. Simpulan penelitian ini adalah kombinasi preemptive analgesia ibuprofen dan parasetamol per oral memiliki efek analgesik yang lebih lama dibanding dengan parasetamol per oral pada pascabedah odontektomi.

 

Comparison of Preemptive Analgesia using Oral Combination of Ibuprofen 75 Milligrams and Paracetamol 250 Milligram and Oral Paracetamol 1 Gram on Duration of Analgesics After Odontectomy

High dose analgesic can cause multiple side effects. Use of analgesics combination enable analgesics to work through different mechanisms and produce a synergistic effect. This study aimed to evaluate the analgesic effects of oral 75 mg ibuprofen and 250 mg paracetamol combination in comparison to oral 1 g paracetamol on post-odontectomy pain. This study was an experimental double blind randomized clinical trial conducted on 26 subjects who underwent odontectomy in Dr. Hasan Sadikin General Hospital Bandung during the period of July‒October 2019. Subjects were divided into P (Paracetamol) group and K (combination) group. Data collected were statistically tested using the Mann-Whitney test. Results showed that the time when post-odontectomy pain started in K group (74.23±15.79 minutes) was significantly longer when compared to that of P group (50.76±17.22 minutes) with p<0.05. The post-odontectomy pain score in K group (2.92±0.75) was also lower than that of P group (3.92±0.86), with p<0.05. In conclusion, oral analgesic agent combinations have a longer analgesic effect than oral paracetamol only in post-odontectomy patients.


Keywords


Ibuprofen, kombinasi analgesik, manajemen nyeri, parasetamol, preemptive analgesia

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References


Koft A, Patel NB. Physiology of pain. Guide to pain management in low-resource settings. Intern Assoc Study Pain. 2010;13:14

Tocher J, Rodgers S, Smith MA, Watt D, Dickson L. Pain management and satisfaction in postsurgical patients. J Clin Nurs. 2012;21(23–24):3361–71.

Buenaventura RM, Adlaka RM, Sehgal NM. Opioid complications and side effects. Pain Physician. 2008;11:105‒20.

Bailey E, Worthington HV, van Wijk A, Yates JM, Coulthard P, Afzal Z. Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth. Cochrane Database Systematic Rev. 2013;12(CD004624).

Hyllested M, Jones S, Pedersen J, Kehlet H. Comparative effect of paracetamol, NSAIDs or their combination in postoperative pain management: a qualitative review. Br J Anaesth. 2002;88(2):199‒214.

Au AHY, Choi SW, Cheung CW, Leung YY. The efficacy and clinical safety of various analgesic combinations for post-operative pain after third molar surgery: a systematic review and meta-analysis. PLoS One. 2015;10(6):e0127611.

Kissin I. Preemptive analgesia. Anesthesiology. 2000;93(4):1138‒43.

Kelly DJ, Ahmad M, Brull SJ. Preemptive analgesia I: physiological pathways and pharmacological modalities. Can J Anaesth. 2001;48(10):1000–10.

Møiniche S, Kehlet H, Dahl JB. A Qualitative and quantitative systematic review of preemptive analgesia for postoperative pain relief the role of timing of analgesia. Anesthesiology: J Am Soc Anesth. 2002;96(3):725–41.

Ahmed SS, ElSharrawy EA, Hamed TA. Clinical evaluation of cox-2 inhibitor for management of post operative complications after odontectomy of impacted lower third molar. J Am Sci. 2014;10(11):60–3.

Aravena PC, Cartes-Velásquez R, Rosas C. Signs and symptoms of postoperative complications in third molar surgery. J Int Dent Med Res. 2015;8(3):140.

Wells LK, Drum M, Nusstein J, Reader A, Beck M. Efficacy of ibuprofen and ibuprofen/acetaminophen on postoperative pain in symptomatic patients with a pulpal diagnosis of necrosis. J Endod. 2011; 37(12):1608–12.

Olson NZ, Otero AM, Marrero I, Tirado S, Cooper S, Doyle G, dkk. Onset of analgesia for liquigel ibuprofen 400 mg, acetaminophen 1.000 mg, ketoprofen 25 mg, and placebo in the treatment of postoperative dental pain. J Clin Pharmacol. 2001;41:1238‒47.

Anderson BJ. Paracetamol (acetaminophen): mechanisms of action. Ped Anesth. 2008;18(10):915–21.

Merry A, Gibbs R, Edwards J, Ting G, Frampton C, Davies E, dkk. Combined acetaminophen and ibuprofen for pain relief after oral surgery in adults: a randomized controlled trial. Br J Anaesth. 2010;104(1):80–8.

Atkinson HC, Currie J, Moodie J, Carson S, Evans S, Worthington JP, dkk. Combination paracetamol and ibuprofen for pain relief after oral surgery: a dose ranging study. Eur J Clin Pharmacol. 2015;71(5):579–87.




DOI: https://doi.org/10.15851/jap.v7n3.1834



 

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