Perbandingan Pemberian Ketorolak dengan Parecoxib Intravena terhadap Kadar Trombosit, Aggregasi Trombosit, dan Profil Koagulasi pada Operasi Seksio Sesarea

Hendra Salim; Muhammad Ramli Ahmad; Syafri Kamsul Arif; Syamsul Hilal Salam; Zulkarnain Arrasjid; Charles Wijaya Tan

doi:10.15851/jap.v9n2.2395

Perbandingan Pemberian Ketorolak dengan Parecoxib Intravena terhadap Kadar Trombosit, Aggregasi Trombosit, dan Profil Koagulasi pada Operasi Seksio Sesarea

Hendra Salim, Muhammad Ramli Ahmad, Syafri Kamsul Arif, Syamsul Hilal Salam, Zulkarnain Arrasjid, Charles Wijaya Tan

Abstract

Pengelolaan nyeri pascabedah bertujuan menghasilkan analgesia yang optimal serta menghambat respons stres akibat pembedahan. Pengaruh OAINS baik COX 1 dan COX 2 terhadap trombosit baik jumlah maupun aggregasinya perlu dinilai untuk menentukan obat terpilih yang aman dalam mengatasi nyeri pascabedah. Penelitian ini bertujuan membandingkan pemberian ketorolak dengan parecoxib intravena terhadap jumlah trombosit, aggregasi trombosit, dan profil koagulasi pada operasi seksio sesarea. Penelitian ini menggunakan uji klinis acak tersamar ganda. Penelitian dilakukan di RSUP Wahidin Sudirohusodo Makassar pada bulan Oktober 2020–Maret 2021. Pengukuran dilakukan di awal dan setelah perlakuan dengan jumlah sampel masing-masing 11 orang. Data dianalisis menggunakan uji statistik Independen T-Test. Tidak berbeda bermakna perubahan kadar trombosit pada pemberian ketorolak dengan parecoxib sebagai analgesia pascabedah seksio pasca 24 jam dan pasca 48 jam (p>0,05). Berbeda bermakna perubahan agregasi trombosit pada pemberian ketorolak dengan parecoxib sebagai analgesia pascabedah seksio pasca 48 jam (p<0,05). Parecoxib tidak menyebabkan penurunan agregasi trombosit sehingga dapat digunakan sebagai alternatif untuk analgetik pascabedah terutama untuk pasien yg mengalami gangguan hemostatis. Parecoxib tidak menyebabkan gangguan faal hemostasis dibanding dengan ketorolak. Parecoxib dan ketorolak tidak memengaruhi jumlah trombosit

Comparison of Intravenous Ketorolac with Parecoxib on Platelet Count, Platelet Aggregation and Coagulation Profile in Caesarean Section

Post-surgical pain management aims to produce optimal analgesia and also inhibit the stress response due to surgery. The effect of NSAIDs, both COX-1 and COX-2, on thrombosis, both in amount and aggregation, need to be assessed to determine which drug is safe for postoperative pain management to compare the administration of intravenous ketorolac with intravenous parecoxib on the platelet count, platelet aggregation and coagulation profile in cesarean section surgery. This study was a randomized double-blind clinical trial. Research site was at Wahidin Sudirohusodo Hospital Makassar from October 2020 to March 2021. Measurements were made at the beginning and after treatment with 11 samples on each group. Data were analyzed using the Independent T-Test. There was no significant difference in platelet count in the administration of ketorolac and parecoxib as analgesia after 24 hours post cesarean section surgery and 48 hours post cesarean section surgery (p>0.05). There was a significant difference in platelet aggregation between ketorolac and parecoxib group after 48 hours of post cesarean section surgery (p<0.05). Parecoxib does not cause a decrease in platelet aggregation; therefore, it can be used as an alternative for post-surgical analgesics, especially for patients with hemostatic disorders. Parecoxib does not cause hemostatic physiological disorders compared to ketorolac. Both parecoxib and ketorolac do not affect the platelet count.

Keywords

Ketorolak, Parecoxib, Aggregasi trombosit, Profil koagulasi

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DOI: https://doi.org/10.15851/jap.v9n2.2395