Perbandingan Kombinasi Tramadol Parasetamol Intravena dengan Tramadol Ketorolak Intravena terhadap Nilai Numeric Rating Scale dan Kebutuhan Opioid Pascahisterektomi

Abstract

Nyeri pascabedah adalah masalah penting dalam pembedahan. Penelitian ini bertujuan membandingkan kombinasi tramadol parasetamol intravena dengan tramadol ketorolak intravena terhadap nilai numeric rating scale (NRS) dan kebutuhan opioid pascabedah histerektomi abdominal. Uji klinik acak terkontrol buta ganda dilakukan terhadap 42 wanita (18–60 tahun) status fisik American Society of Anesthesiologist (ASA) I–II yang menjalani pembedahan histerektomi abdominal dalam anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Agustus–November 2014. Pasien dibagi menjadi dua kelompok, yaitu 21 orang menerima kombinasi tramadol parasetamol intravena dan 21 orang menerima kombinasi tramadol ketorolak intravena yang diberikan saat dilakukan penutupan peritoneum. Penilaian skala nyeri dilakukan dengan menggunakan nilai numeric rating scale baik pada saat istirahat maupun saat mobilisasi. Analisis menggunakan Uji Mann-Whitney. Pada penelitian ini ditemukan nilai NRS pada kelompok tramadol parasetamol dan kelompok tramadol ketorolak tidak berbeda bermakna (p>0,05). Simpulan penelitian ini adalah pemberian kombinasi tramadol parasetamol intravena sebanding dengan kombinasi tramadol ketorolak terhadap nilai NRS dan kebutuhan opioid pascabedah histerektomi abdominal.

Kata kunci: Kebutuhan opioid, ketorolak, numeric rating scale, parasetamol, tramadol

Comparison of Combined Intravenous Tramadol-Paracetamol Versus Tramadol-Ketorolac on Numeric Rating Scale and Opioid Requirement on Post Histerectomy Patients


Postoperative pain is an important problem in surgery. This study aimed to compare the combination of intravenous tramadol paracetamol and tramadol ketorolac to numeric rating scale (NRS) to postoperative opioid requirements in abdominal hysterectomy. Double blind randomized controlled trial was conducted on 42 women (18–60 years) with ASA physical status I–II who underwent abdominal hysterectomy surgery under general anesthesia in Dr. Hasan Sadikin General Hospital Bandung within the period of August–November 2014. Subjects  were divided into two groups: 21 subjects received a combination of intravenous tramadol paracetamol and 21 subjects received combination of intravenous  tramadol ketorolac that was given when peritoneum was closure. The assessment of postoperative pain was performed using a numeric rating scale  both at rest and during mobilization. Correlation analysis is conducted using Mann-whitney test. Result shows that the value of the NRS in group tramadol paracetamol compared to tramadol ketorolac  was not significantly different (p>0.05). This study concludes that the combinations of intravenous tramadol paracetamol and  tramadol ketorolac are the same in terms of the NRS and postoperative opioid requirement after abdominal hysterectomy.

Key words: Ketorolac, numeric rating scale, opioid requirement, paracetamol,  tramadol

DOI: 10.15851/jap.v3n3.612