Research Article

Perbandingan nyeri akut, status hemodinamik, dan efek samping pada pasien low back pain pascalaminektomi antara pemberian terapi adjuvan oksikodon intravena dengan fentanil patch

Sunanda Naibaho , Tjok GB Mahadewa, Tjok Gde Agung Senapathi

Sunanda Naibaho
PPDS-1 Ilmu Bedah, Fakultas Kedokteran, Universitas Udayana-RSUP Sanglah Denpasar, Bali-Indonesia. Email: sunanda_naibaho@yahoo.com

Tjok GB Mahadewa
Departemen/KSM Bedah Syaraf, Fakultas Kedokteran, Universitas Udayana-RSUP Sanglah Denpasar, Bali-Indonesia

Tjok Gde Agung Senapathi
Departemen/KSM Anestesi dan Terapi Intensif, Fakultas Kedokteran, Universitas Udayana-RSUP Sanglah Denpasar, Bali-Indonesia
Online First: August 01, 2020 | Cite this Article
Naibaho, S., Mahadewa, T., Senapathi, T. 2020. Perbandingan nyeri akut, status hemodinamik, dan efek samping pada pasien low back pain pascalaminektomi antara pemberian terapi adjuvan oksikodon intravena dengan fentanil patch. Intisari Sains Medis 11(2): 571-576. DOI:10.15562/ism.v11i2.747


Introduction: Good control of postalaminectomy pain is a determining factor for the success of laminectomy. Although intravenous opioids are widely used, lately fentanyl patches have begun to be considered with the same effectiveness and lower side effects. In this study, an acute comparison of hemodynamic status and side effects in low back pain patients postlaminectomy with intravenous oxycodone adjuvant therapy was compared with fentanyl patches.

Methods: This research is a prospective cohort study by taking a subject of low back pain postlaminectomy at Sanglah General Hospital. The research subjects who approved informed consent, then observed visual analogue scale differences, hemodynamic status, and side effects between groups who received intravenous oxycodone and fentanyl patches. Data were recorded, tabulated, and analyzed with SPSS 16.

Results: This study included 22 subjects who received intravenous oxycodone and fentanyl patch. From VAS 0, 30 and 60 minutes, only in the 60th minute after analgesic administration had significant differences were observed (p=0.005). In this case intravenous oxycodone was significantly better at reducing pain (0.5 vs 1.23) than fentanyl patches. From hemodynamic status, only respiration rates were found that were significantly higher in the intravenous oxycodone group (p=0.037) although not clinically significant (14.73 vs. 15.50). No side effects were found in either group.

Conclusion: There is a difference in pain in low back pain patients with the use of intravenous oxycodone with fentanyl patch, where the effect appears only after 60 minutes. There were no side effects of tightness, nausea and vomiting between the two groups.

 

Pendahuluan: Kontrol nyeri pascalaminektomi yang baik menjadi suatu faktor penentu keberhasilan laminektomi. Walaupun opioid intravena banyak digunakan,  belakangan ini fentanil patch mulai dipertimbangkan dengan efektivitas yang sama dan efek samping yang lebih rendah. Dalam penelitian ini, akan dilakukan perbandingan akut, status hemodinamik, dan efek samping pada pasien low back pain pascalaminektomi dengan pemberian terapi adjuvan oksikodon intravena dibandingkan dengan fentanil patch.

Metode: Penelitian ini berupa studi kohort prospektif dengan mengambil subjek low back pain pascalaminektomi di  RSUP Sanglah. Subjek penelitian yang telah menyetujui informed consent, kemudian diobservasi perbedaan visual analogue scale, status hemodinamik, dan efek samping antara kelompok yang menerima oksikodon intravena dan fentanil patch. Data dicatat, ditabulasi, dan dianalisis dengan SPSS 16.

Hasil: Penelitian ini mencakup masing-masing 22 subjek yang mendapatkan oksikodon intravena dan fentanil patch. Dari VAS 0,30, dan 60 menit, hanya ditunjukkan perbedaan signifikan pada menit ke-60 setelah pemberian analgesik (p=0,005). Dalam hal ini oksikodon intravena secara signifikan lebih baik dalam menurunkan nyeri (0,5 vs 1,23) dibandingkan fentanil patch. Dari status hemodinamik, hanya ditemukan laju respirasi yang secara signifikan lebih tinggi pada kelompok oksikodon intravena (p=0,037) walaupun tidak bermakna secara klinis (14,73 vs 15,50). Tidak ditemukan efek samping pada kedua kelompok.

Simpulan: Ada perbedaan nyeri pada pasien low back pain dengan penggunaan oksikodon intravena dengan fentanil patch, dimana efeknya baru muncul setelah 60 menit. Tidak terdapat adanya efek samping sesak, mual, dan muntah antara kedua kelompok.

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