EFFECTIVENESS OF BILATERAL ERECTOR SPINAE PLANE BLOCK VERSUS TRANSVERSUS ABDOMINIS PLANE AS ANALGESIA AFTER GYNECOLOGIC LAPAROTOMY

Anak Agung Gde Agung Adistaya; Tjahya Aryasa E M; I Gede Budiarta; I Made Gede Widnyana; I Wayan Aryabiantara; IGAG Utara Hartawan; Made Wiryana; Tjokorda Gde Agung Senapathi

doi:10.31004/prepotif.v8i1.27247

Authors

Anak Agung Gde Agung Adistaya Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali
Tjahya Aryasa E M Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali
I Gede Budiarta Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali
I Made Gede Widnyana Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali
I Wayan Aryabiantara Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali
IGAG Utara Hartawan Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali
Made Wiryana Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali
Tjokorda Gde Agung Senapathi Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali

DOI:

https://doi.org/10.31004/prepotif.v8i1.27247

Keywords:

regional block, bilateral erector spinae plane block, bilateral transversus abdominis plane block, analgesia, gynecologic laparotomy

Abstract

ABSTRAK Penelitian ini bertujuan untuk membandingkan efektivitas blok ESP dan TAP terhadap durasi efek analgesik pasca operasi, nyeri pasca operasi, total konsumsi opioid pasca operasi, dan perubahan dalam nilai Neutrophil-Lymphocyte Ratio (NLR) sebelum dan sesudah operasi laparatomi ginekologi. Jenis penelitian ini adalah eksperimental murni (eksperimental sejati). Desain penelitian yang digunakan adalah uji acak tunggal tersamar. Subjek penelitian adalah pasien berusia 18-65 tahun yang menjalani operasi laparatomi ginekologi di ruang operasi Instalasi Bedah Pusat. Analisis data dilakukan dengan bantuan SPSS versi 26 termasuk analisis deskriptif dan uji perbandingan rata-rata menggunakan uji t independen. Blok ESP memiliki durasi analgesik yang lebih lama dengan rata-rata 6.13 ± 3.30 jam sedangkan TAP memiliki durasi analgesia sebesar 3.93 ± 1.98 jam, dengan perbedaan rata-rata sebesar 2.18 jam (IK 95% 0.22-4.15 jam; p = 0.030). Terdapat perbedaan pada skala VAS pada 6, 12, 24, dan 48 jam dengan hasil ESP lebih rendah dari TAP. Rata-rata kebutuhan morfin pada blok ESP adalah 1.62 ± 0.71 mg dan kelompok TAP dengan total kebutuhan rata-rata ± SB 3.31 ± 1.74 mg, perbedaan yang diperoleh adalah 1.68 mg (IK95% 0.72-2.64 mg; p = 0.001). Hasil perbedaan nilai perubahan NLR antara sebelum dan sesudah operasi antara blok ESP bilateral dan TAP ditemukan memiliki perbedaan yang signifikan dengan perbedaan rata-rata sebesar 0.36 (IK 95% 0.04-0.69; P=0.029). Kesimpulan dari penelitian ini adalah blok ESP memiliki efektivitas yang lebih baik dibandingkan dengan blok TAP sebagai analgesia setelah operasi laparatomi ginekologi.

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