Jurnal Anestesi Perioperatif
Vol 8, No 2 (2020)

Perbandingan Pemberian Morfin 15 mg Topikal dengan Bupivakain 0,25% Topikal pada Luka Operasi Modified Radical Mastectomy terhadap Waktu Bebas Nyeri dan Jumlah Kebutuhan Opioid Pascaoperasi

Irwan Setiadi (Departemen Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran/RSUP Dr. Hasan Sadikin Bandung)
M. Andy Prihartono (Departemen Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran/RSUP Dr. Hasan Sadikin Bandung)
Erwin Pradian (Departemen Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran/RSUP Dr. Hasan Sadikin Bandung)



Article Info

Publish Date
30 Aug 2020

Abstract

Berbagai macam analgetik dapat diberikan untuk mengatasi nyeri pascaoperasi mastektomi, namun tidak ada yang ideal dalam menangani nyeri pascaoperasi. Teknik pemberian topikal adalah teknik terbaru untuk penanganan nyeri akut pascaoperasi modified radical mastectomy. Penelitian ini bertujuan membandingkan waktu bebas nyeri dan jumlah kebutuhan opioid pascaoperasi modified radical mastectomy. Penelitian menggunakan metode uji klinis acak terkontrol buta ganda melibatkan 38 pasien yang menjalani operasi modified radical mastectomy di RSUP Dr. Hasan Sadikin Bandung pada bulan November 2019–Februari 2020. Pasien dibagi menjadi dua kelompok, kelompok morfin 15 mg topikal (kelompok M, n=19) dan kelompok bupivakain 0,25% topikal (kelompok B, n=19). Analisis data menggunakan Uji  Mann Whitney karena distribusi data tidak normal berdasar hasil Uji Shapiro-Wilk. Hasil penelitian didapatkan bahwa waktu bebas nyeri lebih lama pada kelompok M (846,78±411,80 menit) dibanding dengan kelompok B (401,52±123,19 menit) dengan perbedaan yang signifikan (p<0,05). Total kebutuhan opioid kelompok M lebih sedikit, yaitu sebesar 1,15±0,60 gram dibanding dengan kelompok B sebesar 3,84±0,89 gram dengan perbedaan yang signifikan (p<0,05). Simpulan penelitian adalah pemberian morfin topikal memberikan waktu bebas nyeri lebih lama dan jumlah kebutuhan opioid pascaoperasi lebih sedikit dibanding dengan pemberian bupivakain topikal untuk nyeri pascaoperasi modified radical mastectomy.Comparison of Postoperative Pain Free Duration and Amount of Opioid Need between Topical 15 mg Morphine and 0.25% Bupivacaine Applications on Modified Radical Mastectomy Surgical Wound Various analgesic methods are implemented for reducing postoperative mastectomy pain, but none of them are ideal. Topical administration is the latest technic for managing postoperative pain in modified-radical mastectomy. This study aimed to compare pain free duration and the amount of opioid needed to manage pain after modified-radical mastectomy. This randomized double-blind clinical trial study with 38 patients underwent modified radical mastectomy in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, was performed from November 2019 to February 2020. Subjects were divided into two groups, with one group received topical 15 mg morphine group (group M, n=19) and another received topical 0.25% bupivacaine group (group B, n=19). Data were analyzed using Mann Whitney test after they were proven to be non-normally distributed based on the results of the Shapiro-Wilk test. Results showed that the pain free duration was significantly longer in group M (846.78±411.80 minutes) when compared to group B (401.52±123.19 minutes) (p<0.05). The total dose needed for group M was 1,15±0,60 grams, which was significantly less than the dose needed in group B (384±0.89 grams) (p<0.05). In conclusion, topical morphine administration is associated with a longer pain free duration before the first onset of pain requiring opioid with less total amount of opioid needed when compared to bupivacaine for modified radical mastectomy postoperative pain.

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Journal Info

Abbrev

jap

Publisher

Subject

Education Health Professions

Description

Jurnal Anestesi Perioperatif (JAP)/Perioperative Anesthesia Journal is to publish peer-reviewed original articles in clinical research relevant to anesthesia, critical care, case report, and others. This journal is published every 4 months with 9 articles (April, August, and December) by Department ...