DOI: https://doi.org/10.14710/jai.v12i1.23718

Efektivitas Lidokain Intravena untuk Mengurangi Nyeri pada Pemberian Drip KCl melalui Akses Vena Perifer

Instalasi Anestesiologi dan Terapi Intensif, RS Akademik UGM, Yogyakarta, Indonesia

Published: 1 Mar 2020.

Citation Format:
Abstract

Latar Belakang: Hipokalemia merupakan gangguan elektrolit yang sering terjadi. Hipokalemia berat dapat mengancam jiwa. Koreksi hipokalemi yang tepat dan cepat dapat mencegah komplikasi yang membahayakan jiwa. Salah satu intervensi yang dapat dilakukan adalah dengan pemberian KCl melalui akses vena perifer, tetapi KCl memiliki sifat iritatif yang dapat menyebabkan nyeri. Cara yang dapat dilakukan untuk mengurangi nyeri adalah dengan pemberian lidokain intravena. Lidokain merupakan obat anestesi yang dapat diberikan secara intravena dan memberikan efek analgesia.

Tujuan: Mengetahui keefektifan lidokain untuk mengurangi nyeri pada pemberian KCl melalui akses vena perifer.

Metode: Penelitian ini merupakan uji klinis randomisasi samar berganda melibatkan 37 pasien hipokalemia yang memerlukan koreksi. Pasien terbagi menjadi 21 pasien kelompok perlakuan (mendapatkan lidokain saat koreksi) dan 16 pasien kelompok kontrol (tanpa lidokain) yang kemudian penilaian nyeri menggunakan numering pain rating scale (NPRS) pada pertengahan proses koreksi (2,5 jam) dan akhir koreksi (5 jam).  

Hasil: Tidak terdapat perbedaan karakteristik dasar di kedua kelompok pada awal penelitian. Pemberian lidokain terbukti dapat mengurangi terjadinya nyeri dari proses koreksi kalium pada pertengahan proses koreksi dan akhir proses koreksi (p<0,05). Pada progresivitas nyeri, pemberian lidokain mampu mencegah terjadinya nyeri pada 2,5 jam pertama (RR=0,47, 95%IK 0,26-0,85, p=0,01) namun progresivitas nyeri 2,5 jam berikutnya tidak bermakna secara statistik (RR=0,95, 95%IK 0,30-2,99, p>0,05).

Kesimpulan: Lidokain dapat mengurangi nyeri selama proses koreksi kalium sehingga dapat dipertimbangkan untuk diaplikasikan dalam praktik klinis.

Note: This article has supplementary file(s).

Fulltext View|Download |  common.other
pproval from Ethics Committee and samples of informed consent
Subject
Type Other
  Download (555KB)    Indexing metadata
 common.other
Copyright JAI
Subject
Type Other
  Download (433KB)    Indexing metadata
 common.other
tabel dan grafik
Subject
Type Other
  Download (66KB)    Indexing metadata
 common.other
Application Form
Subject
Type Other
  Download (3MB)    Indexing metadata
Keywords: drip kcl; lidokain; numeric pain rating scale; nyeri; vena perifer
Funding: RS Akademik UGM Yogyakarta

Article Metrics:

Article Info
Section: Original Articles
Language : ID
Recent articles
Korelasi Kadar Prokalsitonin dan Jumlah Eosinofil pada Pasien Sepsis di Ruang Intensive Care Unit RSUD Dr. Saiful Anwar, Malang Efektivitas Lidokain Intravena untuk Mengurangi Nyeri pada Pemberian Drip KCl melalui Akses Vena Perifer Pencegahan Terjadinya Delayed Cerebral Ischemia (DCI) pada Pasien Aneurysmal Subarachnoid Hemorrhage (aSAH) di Intensive Care Unit Penanganan Inkompatibilitas Darah pada Wanita Hamil yang Menderita Lupus Eritematosus Sistemik Ablasi Radiofrekuensi pada Neuralgia Trigeminal dengan Panduan Fluoroskopi More recent articles
Most cited articles
Midazolam Intravena Dosis Rendah Tidak Mempengaruhi Nitric Oxide Intraperitoneal Mencit Balb/C Yang Terpapar Lipopolisakarida Patofisiologi Penyakit Jantung Koroner More cited articles
  1. Tulungne RS, Tamansa GE, Saerang JSM, Rares LM. Jurnal KEDOKTERAN KLINIK (JKK), Volume 1 No 2 , Desember 2016. J Kedokt Klin (JKK), Vol 1 No 2, Desember 2016. 2016;1(katarak):37–45
  2. Kardalas E, Paschou SA, Anagnostis P, Muscogiuri G, Siasos G, Vryonidou A. Hypokalemia: a clinical update. Endocr Connect. 2018;7(4):R135–46
  3. Palmer BF, Clegg DJ. Physiology and pathophysiology of potassium homeostasis. Adv Physiol Educ. 2016;40(4):480–90
  4. Lim S. Approach to hypokalemia. Acta Med Indones [Internet]. 39(1):56–64. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17297212
  5. Weiner D, Wingo CS. Hypokalemia-consequences, causes, and correction. University of Florida College of Medicine, and Gainesville Veterans Administration Medical Center. 1179-1188
  6. Viera AJ, Wouk N. Potassium Disorders: Hypokalemia and Hyperkalemia. Am Fam Physician [Internet]. 2015;92(6):487–95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26371733
  7. Juan CX, Cheng LL. The effectiveness of intravenous Lidocaine used to treat pain related to peripheral potassium chloride infusion in adult hospitalized patients: a systematic review protocol. JBI Database Syst Rev Implement Reports. 2014;12(9):124–31
  8. Widodo D, Setiawan B, Chen K, Nainggolan L, Santoso WD. The prevalence of hypokalemia in hospitalized patients with infectious diseases problem at Cipto Mangunkusumo Hospital, Jakarta. Acta Med Indones. 2006;38(4):202–5
  9. Asmar A, Mohandas R, Wingo CS. A Physiologic-Based Approach to the Treatment of a Patient With Hypokalemia HHS Public Access. Am J Kidney Dis [Internet]. 2012;60(3):492–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4776048/pdf/nihms396447.pdf
  10. Pek JH, Tan HC, Seth P, Wong E. Reducing Pain Experienced During Potassium Chloride Infusion in the Emergency Department. Eurasian J Emerg Med. 2017;16(4):148–52
  11. Sipahutar TC, Fuadi I, Bisri T. Efek Lidokain Intravena terhadap Nilai Numeric Rating Scale dan Kebutuhan Fentanil Pascaoperasi dengan Anestesi Umum. J Anestesi Perioper. 2014;1(3):167–73
  12. Chan R, Armstrong D. Kalium perifert mindre ont i NaCl. 2004;57(1):27–31
  13. Diseases Branch C, of Health D. Guideline: Peripheral intravenous catheter (PIVC). 2018;28. Available from: https://www.health.qld.gov.au/data/assets/pdf_file/0025/444490/icare-pivc-guideline.pdf
  14. John Ashurst, Shane R. Sergent, Benjamin J. Wagner. Evidence-Based Management Of Potassium Disorders In The Emergency Department. Emerg Med Pract. 2016;18(11)
  15. Daykin H. The efficacy and safety of intravenous lidocaine for analgesia in the older adult: a literature review. Br J Pain. 2017;11(1):23–31
  16. Pucino F, Danielson BD, Carlson JD, Strommen GL, Walker PR, Beck CL, et al. Patient tolerance to intravenous potassium chloride with and without lidocaine. Drug Intell Clin Pharm. 1988;22(9):676–9
  17. Lim ETM, Kloo ST, Tweed WA. Efficacy of lignocaine in alleviating potassium chloride infusion pain. Anaesth Intensive Care. 1992;20(2):196–8
  18. Weinberg L. Pharmacokinetics and pharmacodynamics of lignocaine: A review. World J Anesthesiol [Internet]. 2015;4(2):17. Available from: http://www.wjgnet.com/2218-6182/full/v4/i2/17.htm
  19. Sudigdo S, Ismael S. Dasar-dasar metodologi penelitian klinis 4th Ed. 2011. Jakarta: Sagung Seto
  20. Ahmad WL, Ho CC. The Impact of a Patient Education Package on Outcomes of Pain Management Following Orthopaedic Surgery in a Tertiary Hospital in Malaysia. Med Heal [Internet]. 2015;10(1):58–65. Available from: http://journalarticle.ukm.my/8697/1/8.%2520Ho%2520SE%2520et%2520al.pdf
  21. Wandner LD, Scipio CD, Hirsh AT, Torres CA, Robinson ME. The perception of pain in others: how gender, race, and age influence pain expectations. J Pain. 2012; 13(3): 480-90
  22. Liu J, Lv X. The pharmacokinetics and pharmacodynamics of lidocaine- loaded biodegradable poly(lactic-co-glycolic acid) microspheres. Int J Mol Sci. 2014;15(10):17469–77
  23. Drugs.com. Drug Interaction Between KCl and Lidocaine. [Internet] 2019. [cited 2019 Dec 09]. Available from: https://www.drugs.com/drug-intera ctions/kcl-with-lidocaine-1912-14126-1464-0.html
  24. Pusat Informasi Obat Nasional – Badan Pengawas Obat dan Makanan. Pencarian Interaksi Obat: Lidokain dan KCl. [Internet] 2019. [cited 2019 Dec 09]. Available from: http://ioni.pom.go.id/ioni/cari/interaksi-obat?field_obat_1_value=lidokain &field_obat_2_ value=kalium
  25. Weinberg L. Pharmacokinetics and pharmacodynamics of lignocaine: A review. World J Anesthesiol [Internet]. 2015;4(2):17. Available from: http://www.wjgnet.com/2218-6182/full/v4/i2/17.htm
  26. de Souza MF, Kraychete DC. The analgesic effect of intravenous lidocaine in the treatment of chronic pain: A literature review. Rev Bras Reumatol [Internet]. 2014;54(5):386–92. Available from: http://dx.doi.org/10.1016/j.rbre.2014.01.002
  27. Kurabe M, Furue H, Kohno T. Corrigendum: Intravenous administration of lidocaine directly acts on spinal dorsal horn and produces analgesic effect: An in vivo patch-clamp analysis. Sci Rep [Internet]. 2017;7(April):46814. Available from: http://dx.doi.org/10.1038/srep26253
  28. Yousefshahi F, Predescu O, Asenjo JF. The efficacy of systemic lidocaine in the management of chronic pain: A literature review. Anesthesiol Pain Med. 2017;7(3)
  29. Torp KD, Simon LV. Lidocaine Toxicity. 2019. StatPerls Publishing LLC
  30. Telly O, Cavlak U. Measuring the pain threshold and tolerance using electrical stimulation in patients with type II diabetes mellitus. Journal of Diabetes and Its Complications. 2006; 20(5): 308-316
  31. Upadhyay C, Cameron K, Murphy L, Battistella M. Measuring pain in patients undergoing hemodialysis: A review of pain assessment tools. Clin Kidney J. 2014;7(4):367–72
  32. Müller M, Kamping S, Benrath J, Skowronek H, Schmitz J, Klinger R, Flor H. Treatment history and placebo responses to experimental and clinical pain in chronic pain patients. European Journal of Pain. 2016; 20(9): 1530-1541
  33. Journal I, Studies N, Katip I, Universitesi C, Work AM, On NOG, et al. Extravasations of Vesicant / Non- Vesicant Drugs and Evidence – Based Management. 2014;(January 2012)
  34. Lafreniere JA, Hamilton DP, Carr RR. Assessing the guidelines for potassium replacement in pediatric oncology patients receiving amphotericin B. J Pediatr Pharmacol Ther. 2006;11(4):223–22332
  35. Fink R. Pain Assessment: The Cornerstone to Optimal Pain Management. Baylor Univ Med Cent Proc. 2000;13(3):236–9
  36. Philpott L. Beating pain. Aust J Pharm. 2014;95(1126):42–6

Last update:

No citation recorded.

Last update: 2024-04-17 01:35:00

No citation recorded.