Perbandingan Gabapentin 600 mg dengan Pregabalin 150 mg Preoperatif terhadap Nilai Numeric Rating Scale dan Pengurangan Kebutuhan Opioid Pascaoperasi Modifikasi Radikal Mastektomi

Abstract

Gabapentin dan pregabalin mempunyai efek antihiperalgesia, antialodinia, dan antinosiseptif untuk mengurangi nyeri pascaoperatif. Penelitian ini bertujuan untuk membandingkan gabapentin 600 mg (n=22) dengan pregabalin 150 mg (22) terhadap nyeri pascaoperatif modifikasi mastektomi radikal, yang dilakukan terhadap 44 wanita (18–65 tahun) status fisik American Society of Anesthesiologist (ASA) I-II secara uji acak terkontrol buta ganda dalam anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung pada November 2011 sampai Maret 2012. Analisis statistik menggunakan Uji Mann-Whitney, uji-t dan uji chi-kuadrat dengan tingkat kepercayaan 95% dan bermakna bila p<0,05. Penilaian skala nyeri menggunakan nilai numeric rating scale (NRS). Nilai NRS saat berbaring pada kelompok gabapentin 600 mg dan pregabalin 150 mg adalah sama (p>0,05). Nilai NRS saat mobilisasi pregabalin 150 mg lebih baik daripada gabapentin 600 mg pada tujuh dari sepuluh waktu pengukuran (p<0,05). Pemberian analgetik tambahan pascaoperatif antara kedua kelompok adalah sama (p>0,05). Simpulan, pregabalin 150 mg preoperatif lebih baik dari gabapentin 600 mg dalam menurunkan nilai NRS pascaoperasi. Gabapentin 600 mg dan pregabalin 150 mg mampu menurunkan kebutuhan opioid pascaoperatif.

Kata kunci: Gabapentin, kebutuhan analgetik opioid, numeric rating scale, nyeri pascaoperatif, pregabalin

Comparison of Pre Operative Gabapentin 600 mg and Pregabalin 150 mg to the Value of Numeric Rating Scale and the  Reduction of Post Operative Opioid Requirement after Modified Radical Mastectomy

Gabapentin and pregabalin has anti hiperalgesia, anti allodynia, and anti nocicentive effect that can be used as an additional medication to reduce postoperative pain. This study compared gabapentin 600 mg and pregabalin 150 mg in managing  postoperative pain following modified radical mastectomy.  The study was done by conducting a double blind randomized controlled trial of 44 patients who underwent modified radical mastectomy operation under general anesthesia, aged 18–65 years, with American Society of Anesthesiologist (ASA) physical status I-II at Dr. Hasan sadikin General Hospital Bandung during November 2011 to March 2012. Patients were divided into two groups 600 mg gabapentin (n=22), and 150 mg pregabalin (n=22). Statistical analysis using Mann-Whitney Test, t-test and chi-square test with 95% confidence interval and considered significant if p<0.05. The quality of pain was assessed by using a numeric rating scale. The NRS value at rest was similar in both groups (p>0.05). NRS during mobilization were significantly different in nine measurements (p<0.05). Total postoperative additional analgesia shown no significant differences in both groups (p>0.05). Oral preoperatif pregabalin 150 mg is better than gabapentin 600 mg for reducing post operative NRS. Gabapentin 600 mg and pregabalin 150 mg reduced postoperative opioid consumption.

Key words: Gabapentin, numeric rating scale score, opioid analgesic requirement, post operative, pregabalin

DOI: 10.15851/jap.v2n2.305