Perbandingan Numeric Rating Scale Nyeri Pascaoperasi Kolesistektomi Laparoskopik Antara Blokade Erector Spinae Plane dan Petidin Intravena

Arrys Prabowo, Reza Widianto Sudjud, Ricky Aditya

Abstract


Nyeri pascaoperasi harus diatasi dengan baik. Berbagai metode analgetik dilakukan untuk mengatasi nyeri pascaoperasi kolesistektomi laparoskopik, namun tidak ada yang ideal dalam menangani nyeri pascaoperasi. Blokade erector spinae plane adalah teknik baru untuk penanganan nyeri pascaoperasi kolesistektomi laparoskopik. Penelitian ini bertujuan mengetahui perbedaan nyeri pascaoperasi kolesistektomi laparoskopik yang dinilai dengan NRS nyeri antara pasien yang menggunakan blokade erector spinae plane dan petidin intravena. Penelitian dilakukan pada periode Juni–Oktober 2020 di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini menggunakan metode uji klinis acak terkontrol buta tunggal terhadap 30 pasien. Pasien dibagi menjadi dua kelompok, kelompok petidine intravena (kelompok A, n=15) dan kelompok blokade erector spinae plane (kelompok B, n=15). Nyeri pascaoperasi dinilai dengan NRS pada 0–1 jam, 1–6 jam, 6–12 jam, dan 12–24 jam. Analisis data numerik dengan uji T tidak berpasangan dan Mann Whitney. Data kategorik dengan uji chi square. Skor NRS pada kelompok blokade erector spinae plane lebih rendah dibanding dengan kelompok petidin intravena pada 6–12 jam pascaoperasi (p=0,002) dan kebutuhan rescue analgetik pada 6–12 jam lebih rendah pada kelompok blokade. Metode analgetik blokade erector spinae plane pada pasien pascaoperasi kolesistektomi laparoskopik lebih baik daripada petidin intravena.

 

Comparison of Pain Numeric Rating Scale between Erector Spinae Plane Block and Intravenous Pethidine Post-Laparoscopic Cholecystectomy

 

Postoperative pain is a complaint that must be properly managed. Various analgesic methods are implemented to alleviate laparoscopic cholecystectomy postoperative pain, but none are ideal in managing postoperative pain. Erector spinae plane block is a new technique in laparoscopic cholecystectomy postoperative pain.  This study aims to discover the difference in post laparoscopic cholecystectomy pain measured using the NRS pain scale in patients with erector spinae plane block and intravenous pethidine. The study was conducted between June–October 2020 in Dr. Hasan Sadikin General Hospital Bandung. This was a single blind control trial in 30 patients. Patients were divided into two groups, an intravenous pethidine group (group A, n=15) and an erector spinae plane block group (group B, n=15). Postoperative pain was measured using the NRS pain scale on hour 0–1, 1–6, 6–12, and 12–24. Numerical data was analyzed using the unpaired T test and the Mann Whitney test. Categorical data using the chi square test. NRS measurements in the erector spinae plane block group were lower compared to the intravenous pethidine group in hour 6–12 postoperation (p=0.002) and the need for a rescue analgesic in hour 6–12 lower in the blokade group. The analgesic method erector spinae plane block in patients post laparoscopic cholecystectomy is better than intravenous pethidine.

 


Keywords


Blokade Erector Spinae Plane, Kolesistektomi laparoskopik, Nyeri Pascaoperasi, Pethidine Intravena

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References


Macres SM, Moore PG, Fishman SM. Acute pain management. Dalam: Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, Ortega R, penyunting. Clinical anesthesia. Edisi ke-8. Philadelphia: Wolters Kluwer; 2013. hlm. 3919–4021.

Donatsky AM, Bjerrum F, Gögenur I. Surgical techniques to minimize shoulder pain after laparoscopic cholecystectomy. A systematic review. Surg Endosc. 2013;27(7):2275–82.

Petsas D, Pogiatzi V, Galatidis T, Drogouti M, Sofianou I, Michail A, dkk. Erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy: a case report. J Pain Res. 2018;11:1983–90.

Barazanchi AWH, MacFater WS, Rahiri JL, Tutone S, Hill AG, Joshi GP, dkk. Evidence-based management of pain after laparoscopic cholecystectomy: a PROSPECT review update. Br J Anaesth. 2018;121(4):787–803.

Yang H, Bie B, Naguib MA. Pain physiology. Dalam: Flood P, Rathmell JP, Shafer S, penyunting. Stoelting’s pharmacology & physiology in anesthetic practise. Edisi ke-5 Philadelphia: Lippincot Williams & Wilkin; 2015. hlm. 204–16.

Hurley RW, Murphy JD, Wu CL. Acute postoperative pain. Dalam: Gropper M, penyunting. Miller’s anesthesia. Edisi ke-9. Philadelphia: Elsevier; 2020. hlm. 2614–38.

Aksu C, Kus A, Yörükoglu HU, Kiliç CT, Gürkan Y. The effect of erector spinae plane block on postoperative pain following laparoscopic cholecystectomy: a randomized controlled study. Anestezi Derg. 2019;27(1):9–14.

Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The erector spinae plane block a novel analgesic technique in thoracic neuropathic pain. Reg Anesth Pain Med. 2016;41(5):621–7.

Raichle KA, Osborne TL, Jensen MP, Ehde DM, Smith DG, Robinson LR. Preoperative state anxiety, acute postoperative pain, and analgesic use in persons undergoing lower limb amputation. Clin J Pain. 2015 Aug;31(8):699–706.

Eltumi HG, Tashani OA. Effect of age, sex and gender on pain sensitivity: a narrative review. Open Pain J. 2017;10(1):44–55.

Tulgar S, Selvi O, Kapakli MS. Erector spinae plane block for different laparoscopic abdominal surgeries: case series. Case Rep Anesthesiol. 2018;2018:1–3.

Tulgar S, Kapakli MS, Senturk O, Selvi O, Serifsoy TE, Ozer Z. Evaluation of ultrasound-guided erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy: a prospective, randomized, controlled clinical trial. J Clin Anesth. 2018 April;49:101–6.

Drasner K. Local Anesthetics. Dalam: Katzung BG, Masters SB, Trevor AJ, penyunting. Basic & clinical pharmacology. Edisi ke-12. New York: McGraw-Hill Companies; 2012. hlm. 449–64.

Hannig KE, Jessen C, Soni UK, Børglum J, Bendtsen TF. Erector spinae plane block for elective laparoscopic cholecystectomy in the ambulatory surgical setting. Case Rep Anesthesiol. 2018 Apr;2018:5492527.

Zhang J, He Y, Wang S, Chen Z, Zhang Y, Gao Y, dkk. The erector spinae plane block causes only cutaneous sensory loss on ipsilateral posterior thorax: a prospective observational volunteer study. BMC Anesthesiol. 2020;20(1):1–8.

Kettner SC, Willschke H, Marhofer P. Does regional anaesthesia really improve outcome?. Br J Anaesth. 2011;107(suppl. 1):90–5.

Butterworth JF, Mackey DC, Wasnick JD, penyunting. Morgan & Mikhail’s clinical anesthesiology. Edisi ke-6. United States: McGraw-Hill Education; 2018.




DOI: https://doi.org/10.15851/jap.v9n2.2405



 

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