PERBANDINGAN EFEKTIVITAS ANALGESIA PASCAOPERASI BLOK SUBKOSTAL TRANSVERSUS ABDOMINIS (STA)  DENGAN OPIOID INTRAVENA PADA PASIEN  OPERASI LAPAROSKOPI KOLESISTEKTOMI  DI RSUP PROF. DR. I.G.N.G. NGOERAH  DENPASAR

Dinar Kusuma  Wardani; I.G.P.Sukrana  Sidemen; I.G.A.G. Utara  Hartawan; I Made Gede  Widnyana; Pontisomaya  Parami; Tjahya Aryasa  EM; Made  Wiryana; Tjokorda Gde Agung  Senapathi

doi:10.31004/prepotif.v8i1.27260

Authors

Dinar Kusuma Wardani Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali
I.G.P.Sukrana Sidemen Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali
I.G.A.G. Utara Hartawan 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
Pontisomaya Parami Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali
Tjahya Aryasa EM 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.v8i1.27260

Keywords:

Analgetik, Blok Subkostal Transversus Abdomini, Kolesistektomi, Laparoskopi, Opioid

Abstract

Penelitian ini bertujuan untuk membedakan efektivitas antara blok STA dengan opioid intravena sebagai analgesia pascaoperasi laparoskopi kolesistektomi di RSUP Prof. Dr. I.G.N.G. Ngoerah Denpasar. Penelitian ini merupakan sebuah uji coba prospektif, acak, terkendali dan single-centered. Sebanyak 60 subjek pasien yang menjalani tindakan operasi laparoskopi dibagi menjadi 2 kelompok denganpemberian tindakan STA dan tanpa STA. Analisis data dillakukan dengan bantuan SPSS versi 36 meliputi uji Chi Square, independent t tets dan Mann Whitney. Hasil penelitian bahwa Blok STA pascaoperasi laparoskopi kolesistektomi memiliki intensitas nyeri dengan NRS pada jam ke 6, 12 dan 24 lebih rendah dibandingkan dengan yang hanya mendapatkan opioid intravena dengan nilai p<0,001. Blok STA memiliki total waktu pemberian analgesik rescue pertama 6,67±2,39 jam dan tanpa STA 1,87±0,81 jam dengan perbedaan 4,80 jam (IK95% 3,87-5,72; p<0,001). Blok STA memiliki jumlah muntah dalam 24 jam dengan rerata 0,50±0,97 kali dan tanpa STA 3,27±1,79 kali dengan perbedaan 2,76 kali (IK95% 2,01-3,51; p<0,001). Blok STA memiliki hasil NLR dengan rerata 2,52±1,71 dan tanpa STA 4,64±2,90 dengan perbedaan 2,12 (IK95% 0,89-3,35; p=0,001). Nilai NLR antara sebelum dan sesudah kelompok STA menurun sebesar 1,27±2,64 sedangkan kelompok tanpa STA meningkat rerata 1,33±1,87 dengan perbedaan 2,61 (IK 1,43-3,80; P<0,001). Tindakan blok STA dapat menurunkan efek nyeri, mual-muntah dan durasi analgetik lebih panjang dengan nilai NLR lebih rendah pascaoperasi laparoskopi kolesistektomi dibandingkan dengan tanpa STA.

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