COMPARISON OF CONTINUOUS SUPRAINGUINAL FASCIA ILIACA COMPARTMENT BLOCK (S-FICB) WITH CONTINUOUS EPIDURAL IN PATIENTS UNDERGOING CEPHALOMEDULLARY NAILING SURGERY
DOI:
https://doi.org/10.31004/prepotif.v9i3.42923Keywords:
suprainguinal fascia iliaca compartment block, epidural block, cephalomedullary nailing, postoperative analgesia, interleukin-6, hemodynamic stability, qualities of recovery after surgeyAbstract
Penelitian ini bertujuan untuk membandingkan efektivitas analgesia pascaoperasi, kadar inflamasi, stabilitas hemodinamik, dan kualitas pemulihan pada pasien yang menjalani operasi cephalomedullary nailing dengan menggunakan analgesia terkendali pasien (patient-controlled analgesia atau PCA) berupa blok suprainguinal fascia iliaca compartment block (S-FICB) dan blok epidural kontinu. Penelitian ini merupakan uji klinis komparatif dengan desain single-blind yang melibatkan 46 pasien yang memenuhi kriteria inklusi, dan secara acak dibagi menjadi dua kelompok: kelompok S-FICB dan kelompok epidural. Setelah operasi dengan anestesi spinal, kelompok S-FICB menerima bolus interfascial hydrodissection sebanyak 30 ml ropivakain 0,2%, sementara kelompok epidural menerima bolus awal ropivakain 0,2% sebanyak 10 ml. Infus ropivakain 0,2% kemudian diberikan secara kontinu dengan laju 2 ml/jam selama 24 jam melalui kateter.Kadar Interleukin-6 diukur sebelum dan 24 jam setelah operasi. Kualitas pemulihan pascaoperasi dievaluasi menggunakan skor QoR-40. Hasil penelitian menunjukkan tidak terdapat perbedaan yang signifikan dalam kualitas analgesia pascaoperasi antara kedua kelompok. Namun, penurunan kadar Interleukin-6 secara signifikan lebih besar pada kelompok S-FICB. Ketidakstabilan hemodinamik lebih sering terjadi pada kelompok epidural. Selain itu, skor median total QoR-40 pada 24 jam menunjukkan bahwa kelompok S-FICB memiliki kualitas pemulihan yang lebih baik. Sebagai kesimpulan, S-FICB memberikan analgesia yang sebanding dengan epidural, namun lebih efektif dalam menurunkan kadar Interleukin-6, meningkatkan stabilitas hemodinamik, dan memperbaiki kualitas pemulihan pascaoperasi.References
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