Perbandingan Pengaruh Pemberian Bupivakain 0,25% Intraperitoneum dan Infiltrasi Kulit dengan Plasebo terhadap Nilai Skala Analog Visual Pascaoperasi Laparatomi Ginekologi dengan Anestesi Umum - Ridwan, Romi; Herman, Ruli; ., Suwarman (Majalah Anestesia dan Critical Care, 2016)
Nyeri pascaoperasi adalah masalah penting dalam pembedahan. Studi terbaru menyatakan bahwa pemberiananalgesik perioperatif dapat mencegah serta mengurangi nyeri pascaoperasi. Studi ini bertujuan untuk menjelaskanefek analgesik preemtif dalam penanganan nyeri pascaoperasi laparatomi ginekologi. Jenis penelitian ini adalahprospektif, uji acak terkontrol buta ganda dan uji plasebo-kontrol, dimana 46 pasien dengan American SocietyAssociation (ASA) I dan II yang menjalani operasi laparatomi ginekologi secara acak di central operating theatre(COT), RS. Dr. Hasan Sadikin pada September sampai Desember 2012 diberikan 50 mL bupivakain 0,25% denganepinefrin 5μ per mL atau 50 mL normal salin; setiap 25 mL nya dimasukkan ke dalam rongga peritoneum daninfiltrasi kulit. Skor nyeri pasien dievaluasi dengan sistem Visual Analog Scale (VAS) saat diam dan mobilisasi,dinilai 6 jam pertama, lalu dilanjutkan jam ke- 8,12 dan 24 pascaoperasi. Dihitung jumlah pemakaian analgesikpertolongan selama 24 jam pertama. Hasil penelitian menunjukkan bahwa nyeri saat mobilisasi grup plasebo (P)lebih tinggi dibandingkan dengan grup bupivakain (B). Skor nyeri grup P secara signifikan lebih tinggi daripadagrup B saat mobilisasi (p<0,05). Kombinasi bupivakain secara intraperitoneum dan infiltrasi kulit akhir operasilaparatomi ginekologi dapat mengurangi nyeri pascaoperasi saat mobilisasi. Kata kunci: Bupivakain, intraperitoneum, nilai skala analog visual, nyeri pascaoperasi. Postoperative pain is an important surgical problem. Recent studies shows that perioperative administration ofanalgesics may be possible to prevent or reduce postoperative pain. This study was planned to investigate theefficacy of pre-emptive analgesia on postoperative pain after major gynecologic abdominal surgeries. In thisprospective, double-blinded, randomized, and placebo-controlled trial, 46 ASA physical status I and II patientsundergoing major abdominal gynecologic surgeries were randomized to receive 50 mL of bupivacaine 0.25% withepinephrine 5μ per mL or 50mL of normal saline; each 25 mL of the treatment solution was administered into theperitoneal cavity and incision. The pain score of the patients was evaluated by the visual analogue scale (VAS) atrest and movement, and every hours untill 6h, 8, 12, and 24h after surgery. Pain on movement was significantlymore intense in the Placebo group than in the Bupivacaine group. Measurement of the quality of pain by using theVAS values during mobilization is better than at rest. Pain scores were significantly higher in the placebo groupthan in the bupivacaine group on movement (p<0.05). A combination of intraperitoneal and incisional bupivacaineinfiltration at the end of abdominal gynecologic surgeries reduces postoperative pain on movement. 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