Premedikasi Lidokain dengan Torniket Lebih Baik Dibanding dengan Kombinasi Lidokain dan Propofol untuk Mencegah Nyeri Injeksi Propofol
Abstract
Propofol merupakan jenis obat induksi intravena yang paling sering digunakan dalam pembiusan umum, namun dapat menimbulkan rasa nyeri pada lokasi injeksi. Tujuan penelitian ini adalah mengetahui perbandingan persentase nyeri pascainjeksi propofol setelah premedikasi lidokain dengan perlakuan torniket selama satu menit dan teknik campuran lidokain fropofol. Penelitian ini merupakan uji klinis tersamar tunggal bersifat eksperimental. Penelitian dilaksanakan di RSUD Dr. Saiful Anwar pada April–Mei 2013. Subjek penelitian adalah 50 pasien yang dibagi menjadi dua kelompok secara acak. Kelompok A (n=25) mendapat perlakuan campuran 40 mg lidokain dalam propofol intravena (i.v.). Kelompok B (n=25) mendapat perlakuan lidokain 40 mg (i.v.) dengan perlakuan torniket selama satu menit, diikuti injeksi propofol. Derajat nyeri diukur menggunakan Verbal Rating Score. Hasil pengukuran dianalisis statistik dengan uji normalitas, homogenitas, dan Mann Whitney menggunakan software SPSS (versi 18, IBM Statistic, USA). Pemberian lidokain dengan perlakuan torniket signifikan dapat merunkan detajat nyeri lebih baik (24/25 tidak nyeri, 1/25 nyeri) dibanding dengan kelompok campuran lodokain dan propofol (10/25 tidak nyeri, 11/25 nyeri ringan, 4/25 nyeri sedang) (p=0,000). Premedikasi lidokain dengan perlakuan torniket lebih baik dalam menurunkan derajat nyeri dibanding dengan pemberian campuran lidokain dan propofol.
Premedication Using Lidocaine with Tourniquet Technique is Superior to Combining Lidocaine and Propofol to Prevent Propofol Injection Pain
Propofol is one of the most used intravenous induction drugs in general anesthesia, but it produces pain at the injection site. This study aimed to compare the post-propofol injection pain after premedication using lidocaine with the tourniquet technique and a mixture of lidocaine in propofol. This study was a single-blind, experimental clinical trial conducted from April to May 2013. The study's subject was 50 patients divided into two groups. Group A (n=25) received a mixture of 40 mg lidocaine in propofol intravenously (i.v.). Group B (n=25) received 40 mg lidocaine (i.v) with a tourniquet technique for one minute, followed by propofol injection. The degree of pain is measured using the Verbal Rating Score. The results were statistically analyzed using the normality, homogeneity, Mann-Whitney test using SPSS (version 18, IBM Statistic, USA) software. The administration of lidocaine with the tourniquet technique was significantly better in reducing the pain levels (24/25 painless, 1/25 mild pain) compared to the mixture of lidocaine in the propofol group (10/25painless, 11/25 mild pain, 4/25 moderate pain) (p= 0,000). The premedication of lidocaine with the tourniquet technique significantly produces lower pain levels than the mixture of lidocaine in propofol. Premedication of lidocaine with a tourniquet technique can prevent pain after injecting propofol.
Full Text:
PDFReferences
Miller RD, Eriksson L, Fleisher L, Wienner J, Young WL. Miller’s Anesthesia. Edisi ke-7 California. Elsevier; 2009.
Soenarto, Ratna F, Chandra S. Buku ajar anestesiologi. Jakarta. Departemen Anestesiologi dan Intensive Care FKUI; 2012.
Sethi N, Jayaraman L, Sethi M, Sharma S, Sood J. Prevention of propofol pain: a comparative study. Middle East J Anesth. 2009;20(2):71–4.
Lee P, Russell W. Preventing pain on injection of propofol: a comparison between lignocaine pre-treatment and lignocaine added to propofol. Anaesth Intensive Care. 2004;32(4):482–4. doi:10.1177/0310057X0403200432
Massad I, Abu-Ali H, Abu-Halaweh S, Badran I. Venous occlusion with lidocaine for preventing propofol induced pain. A prospective double-blind randomized study. Saudi Med J. 2006;27(7):997–1000.
Morgan G, Mikhail M, Murray M. Clinical anesthesiology. Edisi ke-4. New York: Mc-Graw Hill; 2006.
Mahmood I, Yasmine M. Prevention of pain on propofol injection: a comparative, randomize, double blind study between lignocain, ketamine, dexamethasone, and placebo. Prof Med J. 2010;17(3):405–10.
Simoni RF, Miziara LE, Esteves LO, D'Castro JG, Morales CA Jr, Sandrin CE, dkk. Pharmacodynamic evaluation and physical/chemical analysis of two formulations of propofol used in target-controlled infusion. Braz J Anesthesiol. 2013;63(1):59–65.
Desousa KA. Pain on propofol injection: Causes and remedies. Indian J Pharmacol. 2016;48(6):617–23.
Story G, Peier A, Reeve AJ, Eid SR, Mosbacher J, Hricik TR dkk. ANKTM1, a TRP-like channel expressed in nociceptive neurons, is activated by cold temperatures. Cell. 2003;112(6):819–29.
Fischer M, Leffler A, Niedermirtl F, Kistner K, Eberhardt M, Ree P. The general anesthetic propofol excites nociceptors by activating TRPV1 and TRPA1 rather than GABAA receptors. J Biol Chem. 2010;285:34781–92.
Ray S, Pal R, Pal S, Al E. Preclusion of pain on injection with propofol: evaluating the effects of lignocaine or fentanyl pretreatment. Anesth Essays Res. 2011;5(1):33–8.
Sim JY, Lee SH, Park DY, Jung JA, Ki KH, Lee DH dkk. Pain on injection with microemulsion propofol. Br J Clin Pharmacol. 2009;67(3):316–25.
EEuasobhon P, Dej-Arkom S, Siriussawakul A, Muangman S, Sriraj W, Pattanittum P, dkk. Lidocaine for reducing propofol-induced pain on induction of anaesthesia in adults. Cochrane Database Syst Rev. 2016;2(2):CD007874. .
Kurabe M, Furue H, Kohno T. Intravenous administration of lidocaine directly acts on spinal dorsal horn and produces analgesic effect: An in vivo patch-clamp analysis [published correction appears in Sci Rep. 2017 Jun 01;7:46814]. Sci Rep. 2016;6:26253.
Picard P, Tramer M. Prevention of pain on injection with propofol: a quantitative systemic review. Anaesth Analg. 2000;90:963–9.
Jalota L, Kalira V, George E, Shi YY, Hornuss C, Radke O, dkk. Prevention of pain on injection of propofol: systematic review and meta-analysis. BMJ. 2011;342(7799):694.
Wong W, Cheong K. Role of tramadol in reducing pain on propofol injection. Singapore Med J. 2001;42:193–5.
Koo S, Cho S, Ham K, Hwang J. Small dose ketamine reduce the pain of propofol injection. Anesth Analg. 2006;103(6):1444–7.
Zahedi H, Nikooseresht M, Seifrabie M. Prevention of propofol injection pain with smalldose ketamine. MEJ Anesth. 2009;20(3):401–4.
DOI: https://doi.org/10.15851/jap.v9n3.2382
Article Metrics
Abstract view : 570 timesPDF - 309 times
This Journal indexed by
JAP is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
View My Stats