Perbandingan Efek Lidokain dengan Magnesium Sulfat Intravena terhadap Nilai Numeric Rating Scale dan Kebutuhan Analgesik Pascabedah Kolesistektomi Perlaparoskopi

Abstract

Lidokain dan magnesium sulfat mempunyai efek antihiperalgesia yang dapat digunakan sebagai obat tambahan untuk mengurangi nyeri pascaoperasi dan mengurangi kebutuhan analgesik opioid. Tujuan penelitian ini membandingkan efek lidokain dan magnesium sulfat intravena nilai numeric rating scale (NRS) dan kebutuhan analgesik pertolongan. Penelitian eksperimental dengan double blind randomized controlled trial dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Januari–Maret 2015 terhadap 30 pasien yang menjalani kolesistektomi per laparoskopi. Pasien dikelompokkan menjadi 2. Kelompok lidokain mendapatkan 1 mg/kgBB intravena dilanjutkan dengan 1 mg/kgBB/jam dan kelompok magnesium sulfat mendapatkan 30 mg/kgBB intravena dilanjutkan dengan 10 mg/kgBB/jam. Data hasil penelitian dianalisis menggunakan Uji Mann-Whitney, uji-t, dan dianggap bermakna bila p<0,05. Hasil analisis statistik menunjukan bahwa lidokain mengurangi nilai NRS secara bermakna dibanding dengan magnesium sulfat pada jam ke-4 pascaoperasi (p<0,05), dengan kebutuhan analgesik pertolongan fentanil pada kelompok lidokain rata-rata 66,4±15,2 µg dan pada kelompok magnesium sulfat rata-rata 86,0±7,8 µg. Simpulan, lidokain intravena mengurangi NRS pascaoperasi lebih baik dan mengurangi kebutuhan opioid lebih banyak dibanding dengan magnesium sulfat pada pasien operasi kolesistektomi per laparoskopi.

Kata kunci: Kebutuhan analgesik opioid, lidokain, magnesium sulfat, nyeri pascaoperasi, numeric rating scale

Comparison between the Effect of Intravenous Lidocaine and Magnesium Sulphate on Numeric Rating Scale and Postoperative Analgetic Requirement for Laparoscopic Cholecystectomi

Abstract

Postoperative pain management after laparoscopic cholecystectomy is one measure of successful anesthesia and surgery. Lidocaine and magnesium sulphate have anti-hyperalgesia effects applicable as an additional medication to attenuate postoperative pain and reduce the need for opioid analgesics. A total of 30 of patients aged 18–65 years with ASA physical status I–II who underwent laparoscopic cholecystectomy in Dr. Hasan Sadikin General Hospital Bandung were included in a double-blind, randomized, controlled clinical trial. Patients were randomly assigned into 2 groups. The L group, treated with 1 mg/kgBW intravenous followed by 1 mg/kgBW/h intravenous, and M group, treated with 30 mg/kgBW intravenous followed by 10 mg/kgBW/h. Data were analyzed using Mann-Whitney Test and t-test, p<0.05 was considered significant. Statistical analysis showed that lidocaine significantly reduced NRS value compared to magnesium sulphate at 4 hours postoperatively (p<0.05), with the average rescue analgesic fentanyl requirement in the lidocaine group and the magnesium sulphate group of 66.4±15.2 mg and 86.0±7.8 g, respectively. In conclusions, intravenous lidocaine administration may reduce the postoperative NRS value and opioid analgetic requirement more than the intravenous magnesium sulphate administration in patients undergoing laparoscopic cholecystectomy.

Key words: An opioid analgetic rescue, lidocaine, magnesium sulphate postoperative pain, numeric rating scale

DOI: 10.15851/jap.v4n1.741