Pengaruh Blok Peritonsiler Levobupivakain Isobarik 0,125% terhadap Intensitas Nyeri dan Kadar Interleukin 6 Pascatonsilektomi

Herman Mangasi Silaban, Ari Santri Palinrungi, Muh. Ramli Ahmad, Syamsul Hilal Salam, Alamsyah Ambo Ala Husain, Charles Wijaya Tan

Abstract


Nyeri pascatonsilektomi memengaruhi banyak aspek pada pasien. Intensitas nyeri berhubungan dengan kadar interleukin (IL)-6 yang meningkat pada proses inflamasi. Levobupivakain merupakan anestesi lokal potensi tinggi dengan durasi kerja panjang dan onset kerja relatif lambat. Penelitian ini bertujuan mengetahui pengaruh blok peritonsiler levobupivakain isobarik terhadap intensitas nyeri dan kadar interleukin 6 pascatonsilektomi. Penelitian ini merupakan penelitian eksperimental dengan desain uji klinis acak tersamar tunggal yang dilakukan di Rumah Sakit Perguruan Tinggi Negeri Universitas Hasanuddin dan Rumah Sakit jejaring pendidikan pada bulan Desember 2023–Januari 2024. Pasien dibagi secara acak dalam dua kelompok yaitu kelompok intervensi (diberikan levobupivakain isobarik pascabedah) dan kontrol. Intensitas nyeri, jumlah opioid, dan efek samping pada 4, 8, 12, 24 jam pascabedah dievaluasi. Pemeriksaan IL-6 dilakukan sebelum pembedahan dan 12 jam pascabedah. Total 30 pasien diikutkan dengan 15 pasien pada tiap kelompok. Intensitas nyeri pascabedah pada kelompok kontrol lebih tinggi secara signifikan dibanding dengan kelompok intervensi pada 2, 4, 6, hingga 8 jam pascabedah (P<0,05). Perubahan kadar IL-6 pascabedah juga berbeda secara signifikan (p=0,033) dengan kelompok kontrol (74,56±33,79) mengalami kenaikan lebih tinggi dibanding dengan kelompok intervensi (44,67±45,44). Simpulan didapatkan bahwa levobupivakain isobarik dapat menurunkan intensitas nyeri dan kadar IL-6 pascatonsilektomi.

 

Keywords


Interleukin-6; levobupivakain; intensitas nyeri; tonsilektomi

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References


  1. Thomas J, Bhatnagar A, Satav A V, Kancherla S, Prasad S, Pareek R. To study the effect of pre-incisional infiltration of ropivacaine for post-tonsillectomy pain relief. Int. J. Otorhinolaryngol.Clin. 2023;14(3):79–81.
  2. Lahane PV, Nandanvankar NK, Pradeep MS, Memon NY, Yennawar SD. A comparative study of intraoperative peritonsillar infiltration versus intravenous dexemedetomidine for perioperative analgesia in tonsillectomy. Asian J Med Sci. 2020;11(6):89–95.
  3. Sebba A. Pain: A review of interleukin-6 and its roles in the pain of rheumatoid arthritis. Open Access Rheumatol. 2021;13:31–43.
  4. Zhou YQ, Liu Z, Liu ZH, Chen SP, Li M, Shahveranov A, dkk. Interleukin-6: an emerging regulator of pathological pain. J Neuroinflammation. 2016;13(1):1–9.
  5. Sathyanarayana LA, Heggeri VM, Simha PP, Narasimaiah S, Narasimaiah M, Subbarao BK. Comparison of epidural bupivacaine, levobupivacaine and dexmedetomidine in patients undergoing vascular surgery. J. Clin. Diagn. Res. 2016;10(1):UC13–7.
  6. Athar M, Ahmed SM, Ali S, Doley K, Varshney A, Siddiqi MohdMH. Levobupivacaine or ropivacaine: a randomised double blind controlled trial using equipotent doses in spinal anaesthesia. Colombian Journal of Anesthesiology. 2016;44(2):97–104.
  7. Rakesh BS, Bharathi MB, Thanzeemunisa U, Kumar S De, Aggarwal N. Local bupivacaine infiltration to reduce pain after tonsillectomy: a low cost approach. Bengal J. Otolaryngol. Head Neck Surg. 2021;28(3):228–33.
  8. Brown EN, Pavone KJ, Naranjo M. Multimodal general anesthesia: theory and practice. Anesth Analg. 2018;127(5):1246–58.
  9. Turhan KSC, Salviz EA, Beton S, Timuroglu ST, Catav S, Ozatamer O. Peritonsillar infiltration with levobupivacaine for posttonsillectomy pain relief: does concentration have any effect? a double-blind randomized controlled clinical study. Eur Rev Med Pharmacol Sci. 2015;19(7):1276–84.
  10. Erdogan BA, Aydin S, Paksoy M, Sanli A, Sevim S. Efficacy of preincisional levobupivacaine for adult tonsillectomy patients. B-ENT. 2014;10(3):193–7.
  11. Alotaibi AA, Carpenter D, Asdaq SMB. Critical review on the efficacy and safety of levobupivacaine peritonsillar infiltration. Saudi J Biol Sci. 2022;29(4):2056–62.
  12. Abo Elfadl GM, Abdelrady MM, Osman HM, Gad MO, Abd El-Rady NM, Ali WN. Efficacy of levobupivacaine Versus Levobupivacaine Plus Dexmedetomidine Infiltration for Post-Tonsillectomy Analgesia: A Randomized Controlled Trial. Pain Res Manag. 2022;2022:9958668.
  13. Alende-Castro V, Alonso-Sampedro M, Gude F, Gonzalez-Quintela A. Serum Concentrations of Interleukin 6 in the General Adult Population: Possible Implications for Anti-IL-6 Therapy in SARS-Cov-2 Infection and IL-6-Related Diseases. J Investig Allergol Clin Immunol. 2021;31(1):75–8.
  14. Isbul I, Ahmad MuhR, Gaus S, Ratnawati R, Musba AMT, Wijaya Tan C. Efek anestesi infiltrasi terhadap intensitas nyeri dan kadar interleukin-6 pada pasca seksio sesarea. Jurnal Anestesi Obstetri Indonesia. 2023;6(1):8–16.
  15. Zhou YQ, Liu Z, Liu ZH, Chen SP, Li M, Shahveranov A, dkk. Interleukin-6: an emerging regulator of pathological pain. J. Neuroinflammation. 2016;13(1):1–9.
  16. Cicekci F, Sizer C, Atici SS, Arican S, Karaibrahimoglu A, Kara I. Comparison of the perioperative and postoperative effects of levobupivacaine and of levobupivacaine + adrenaline in pediatric tonsillectomy: a double-blind randomized study. Pain Res Manag. 2017;2017:1–8.
  17. Azis S, Ali N, Ilyas M, dkk. Comparing the efficacy of ibuprofen alone with ibuprofen and paracetamol in combination in relieving post tonsillectomy pain in children: a prospective comparative study. J Health Rehab Res. 2024;4(1):1243–7.
  18. Kim MS, Choi HG, Park EK, Kim SY, Kim JH, Park B. Natural course of tonsillectomy pain: a prospective patient cohort study. Auris Nasus Larynx. 2018;45(3):508–13.
  19. Aysenur D, Mine C, Ozgur Y, Ahmet AH, Fuat EA, Ilker I, dkk. Pre-emptive peritonsillar dexamethasone vs. levobupivacaine infiltration for relief of post-adenotonsillectomy pain in children: a controlled clinical study. Int J Pediatr Otorhinolaryngol. 2014;78(9):1467–71.




DOI: https://doi.org/10.15851/jap.v12n2.3866

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