Perbandingan Efek Parasetamol 1 gr/6 jam Intravena dan Ketorolak 30 mg/6 jam Intravena Untuk Penanganan Nyeri Paska Pembedahan Seksio Sesaria Dengan Anestesi Regional Blok Subaraknoid
| Main Author: | Gunawan, Rudy |
|---|---|
| Format: | Masters |
| Bahasa: | ind |
| Subjects: | |
| Online Access: |
http://repository.usu.ac.id/handle/123456789/31992 |
Daftar Isi:
- Background : Post-surgical pain in cesarean section is a major problem because if the pain is not addressed well it will cause a negative impact on post surgical patients and ultimately affects the quality of infant care by his mother. Opioid therapy is the main option for post-surgical pain, but the usage is limited due to the side effects such as respiratory depression, sedation, nausea, vomiting, and pruritus. Nonsteroidal anti-inflammatory drugs (NSAIDs) is now widely used as a substitute for opioids, however giving NSAIDs also have side effects such as increased bleeding time, injury to the gastrointestinal organs, dyspepsia, kidney disorders, nausea, headache, somnolence, drowsiness, palpitations and pruritus. Because of the administration of NSAIDs may also pose risks that can harm the patient, then paracetamol which is safe to use, has minimal side effects, well tolerated, and also has the analgesia power for post-surgical pain management mild, moderate or severe is now considered. Methode : Research was done with randomized controlled clinical trials, double-blind. Fifty patients, ASA 1-2, aged 20-30 years, that underwent emergency surgery cesarean section with subarachnoid block regional anesthesia, was randomly divided to determine the analgesia post surgery in group I (paracetamol 1 g / 6 h) or group II (30 mg ketorolac / 6 hours). VAS values in both groups were compared at resting position and while moving, side effects and additional analgesia requirements after surgery were also noted at 0, 1st, 2nd, 3rd, 4th, 6th, 9th, 12th, 18th and 24th hour post surgery. Result : The results of post-surgical pain evaluation by Visual Analogue Scale VAS values found at resting position have no significant difference at the 1st hour (p=0:08), 2nd hour (p=0:42), 4th hour (p=0:56), 6th hour (p=0.06), 18th hour (p=1.00) and 24th hour (p=0.71) post-surgery, as well as the results obtained that have significant differences were at the 3rd hour (p=0.02), 9th hour (p<0.01 ) and the 12th hour (p=0.02) post surgery in both groups. VAS values while moving in both groups have no significant difference at 1st hour (p=0.06), 2nd hour (p=0.90), 4th hour (p=0.11), 6th hour (p=0.07), 9th hour (p=0:56) and 24th hour (p=0.62) post-surgery, while the results obtained that have significant differences was found at the 3rd hour (p=0.03), 12th hour (p=0.04), 18th hour (p=0.02) post surgery. Administration of ketorolac could cause nausea while paracetamol did not, but statistically the difference from both of these groups proved meaningless. Giving paracetamol or ketorolac equally requires additional analgesias to achieve VAS value 1-4 and the two groups were statistically found to have no significant difference. Conclusion: Paracetamol can be used as an alternative drug to ketorolac in order to overcome post-surgical pain cesarean section, because it has an equivalent analgesia effect as ketorolac. Administration of paracetamol and ketorolac can not be used as a single drug therapy for pain management in post caesarean section.
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