Perbedaan Nilai Agregasi Trombosit Akibat Pengaruh Penggunaan Analgesia Ketorolak dan Ibuprofen Intravena Pascaoperasi di RSUP Haji Adam Malik Medan
Abstract
Obat anti-inflamasi nonsteroid (OAINS) merupakan analgetik yang sering digunakan pada pascaoperasi bedah ortopedi. Penelitian ini bertujuan melihat apakah terdapat perbedaan nilai agregasi trombosit akibat pengaruh penggunaan analgestik ketorolak dengan ibuprofen intravena setelah operasi. Penelitian ini merupakan penelitian uji klinis dengan uji acak tersamar buta ganda yang membandingkan perbedaan pengaruh ketorolak 30 mg intravena/6 jam dengan ibuprofen 800 mg intravena/6 jam. Populasi penelitian ini adalah pasien yang menjalani tindakan pembedahan elektif dengan anestesi umum di RSUP Haji Adam Malik Medan pada bulan Agustus 2016. Pasien dibagi menjadi 2 kelompok dengan tiap-tiap kelompok berjumlah 20 pasien. Ketorolak atau ibuprofen sebagai analgetik diberikan setelah 30 menit selesai operasi, kemudian dilanjutkan per 6 jam sampai dengan 2 hari selesai operasi. Uji statistik menggunakan tes Wilcoxon untuk sebelum perlakuan dan Uji Mann-Whitney untuk sesudah perlakuan pada kedua kelompok. Data karakteristik subjek homogen. Agregasi trombosit pada kelompok ketorolak dengan kelompok ibuprofen berbeda bermakna setelah 10 menit ekstubasi dengan 8 jam setelah pemberian obat terakhir. Tidak terdapat perbedaan bermakna antara kelompok ketorolak dan kelompok ibuprofen setelah 10 menit ekstubasi (p>0,05), namun terdapat perbedaan bermakna pada 8 jam setelah akhir pemberian obat. Simpulan, ketorolak menurunkan persentase agregasi trombosit lebih besar daripada ibuprofen setelah 8 jam pemberian obat terakhir.
Differences in Platelet Aggregation Values in Postoperative Intravenous Ketorolac and Ibuprofen Analgesics at Haji Adam Malik Central General Hospital Medan
Non-steroidal anti-inflammatory drugs (NSAIDs) are analgesics used for postoperative orthopedic surgery. This study aimed to underrstand the effect of intravenous ketorolac and ibuprofen on platelet aggregation values. This was a double-blind randomized controlled trial that compared the effects of intravenous ketorolac and ibuprofen. The population of this study were patients undergoing elective surgery under general anesthesia at Haji Adam Malik Central General Hospital Medan in August 2016. Patients were divided into 2 groups (n: 20): ketorolac group andibuprofen group. Both group received analgesic 30 minutes after surgery up to 2 days postoperative. The statistical tests used were Wilcoxon test for pre-treatment and Mann-Whitney test for post-treatment in each group. Subject characteristic data were homogenous. Platelet aggregation of ketorolac and ibuprofen groups differed significantly between 10 minutes after extubation and 8 hours after the last drug administration. There was no significant difference between the ketorolac and ibuprofen groups after 10 minutes of extubation (p>0.05); however there was a significant difference at 8 hours after the end of drug administration. In conclusion, ketorolac decreases platelet aggregation percentage greater than ibuprofen after 8 hours of the last drug administration.
Keywords
Full Text:
PDFReferences
Shrestha A, Huang D. Intravenous ibuprofen as an adjunct in acute postoperative pain. JSAN. 2015;2(1):21–4.
Ahiskalioglu EO, Ahiskalioglu A, Aydin P, Yayik AM, Temiz A. Effects of single-dose preemptive intravenous ibuprofen on postoperative opioid consumption and acute pain after laparoscopic cholecystectomy. Medicine (Baltimore). 2017;96(8):e6200–1.
Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA. 2008;287(19):2570–81.
Dame L, Bisri T, Wargahadibrata H. Perbandingan deksketoprofen trometamol 1,5 mg/kgBB dan petidin 1 mg/kgBB intravena sebagai analgetik intraoperasi dan kejadian efek samping pascaoperasi pada pasien bedah rawat jalan RSUP Dr. Sadikin Bandung. Anesth Crit Care. 2007;2007(25):217–20.
Hintzen C. Double-blinded randomized trial of IV ibuprofen and morphine combination therapy in patients presenting to the emergency department with renal colic. [PhD dissertation]. Arizona: The University of Arizona; 2015.
Rahman K, Lowe G, Smith S. Aged garlic extract inhibits human platelet aggregation by altering intracellular signaling and platelet shape change. J Nutr. 2016;146(2):410S–5.
Stoelting RK, Miller RD, penyunting. Fluid and blood therapy: basics of anaesthesia. Edisi ke-4. Philadelphia: Churchill Livingstone; 2016.
Singla L, Rock A, Pavliv L. A multi-center, randomized, double-blind placebo-controlled trial of intravenous-ibuprofen (IV-ibuprofen) for treatment of pain in post-operative orthopaedic adult patients. Pain Med. 2010;11(8):1284–93.
Hong Y, Gengo FM, Rainka MM, Bates VE, Mager DE. Population pharmacodynamic modelling of aspirin- and ibuprofen-induced inhibition of platelet aggregation in healthy subjects. Clin Pharmacokinet. 2008;47(2):129–37.
Burke A, Smyth E, Fitzgerald GA, penyunting. Analgesic-antipyretic agents: Goodman & Gilman’s the pharmacological basis of therapeutics. Edisi ke-11. New York: The McGraw- Hill Companies; 2009.
Southworth S, Peters J, Rock A, Pavliv L. A multicenter, randomized, double-blind, placebo-controlled trial of intravenous ibuprofen 400 and 800 mg every 6 hours in the management of postoperative pain. Clin Therapeut. 2009;31(9):1922–35.
Gupta A, Abubaker H, Demas E. A randomized trial comparing the safety and efficacy of intravenous ibuprofen versus ibuprofen and acetaminophen in knee or hip arthroplasty. Pain Physic. 2016;19(1):349–56.
Silva BR, Pernomian L, De Paula TD, Grando MD, Bendhack LM. Endothelial nitric oxide synthase and cyclooxygenase are activated by hydrogen peroxide in renal hypertensive rat aorta. Eur J Pharmacol. 2017;813(1):1–5.
Fries D, Innerhofer P, Klinger A, Berresheim U, Mittermayr M, Calatzis A, dkk. The effect of the combined administration of colloids and lactated ringer’s solution on the coagulation system: an in vitro study using thrombelastograph® coagulation analysis (ROTEG®). Anesth Analg. 2009;94(5):1280–7.
Ratri S, Perbedaan pengaruh pemberian ketorolak dan deksketoprofen sebagai analgesia pasca bedah terhadap agregasi trombosit. Eprints.undip.ac.id. 2009
Martini. Original research article a multi-center, randomized, double-blind placebo-controlled trial of intravenous-ibuprofen (IV-ibuprofen) for treatment of pain in post-operative orthopedic adult patients. Pain Med. 2015;11:1284–93.
DOI: https://doi.org/10.15851/jap.v5n3.1166
Article Metrics
Abstract view : 1205 timesPDF - 1399 times
This Journal indexed by
JAP is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
View My Stats